Q&A 5/10/22 Brain Inflammation, Anxiety, Depression, Thyroid, Digestive Problems


Podcast Highlights:

01:55 Keep Your Mind Healthy So You Can Help in Meaningful Ways

04:00 The Neurotransmitter Paradigm

05:19 SSRI’s:  An Occasional solution for an occasional Problem

07:21 CYTOKINE STORMS: The Healing Inflammatory Process Run Amok

11:32 Ibuprofen and Gluten positive correlation to Leaky Gut

13:26 lactobacillus rhamnosus

15:29 Anxiety: Sign of Vitality or Illness

19:35 Fight or Flight mode is bad for the gut

20:54 The Adrenals They’re Talking, Who’s Listening

25:38 2nd Hand News, Cortisol handcuffs, treating all the malaise indicated

28:10 The Organic Acids Test:  The New Swiss Army Knife

Transcript from Webinar:

Howdy all! This is Dr. John. I want to apologize. I’m a couple of minutes late today. I was actually tied up in another webinar, so I couldn’t quite get here. I’m going to finish what I started last week. In fact, I am going to use the same presentation. I’m just going to continue it a little bit further.  The question was about anxiety and whether the gut connection can stimulate anxiety and/or depression.


Anxiety and depression : Brain on Fire

I’m often asked if there is good evidence to support the assertion that anxiety and depression can be caused by gut inflammation. How common is it this itiology for anxiety?”  My emphatic response is always, “Oh, my God – there’s tons of evidence!” One of the things to remember is that there has been a massive increase of anxiety.    It has gone from 8%, roughly to over 25%, between 2019 and the present.  Now, 8% was way too high.  However 25%, a quarter of the people walking around, are having diagnosed anxiety. That’s people who are being told by their doctors that they medically have an anxiety condition.  You can multiply that a few times when you look at the people that actually have anxiety and aren’t included in that number. Depression almost quadrupled up to over 24%.  I went through a lot of the reasons that that happens. If you’re interested, you can take a look at that.


Keep Your Mind Healthy So You Can Help in Meaningful Ways
We see some of the fear, the panic, the hopelessness through our overuse of news media and social media. . If you have anxiety, you just have to shut everything off.       Now, if you’re going to devote your life to changing those things, God bless you. I’ll support you. If you’re not and you have anxiety, get out of the news media. They are lying 99% of the time. They make this stuff up. I used to have a channel that I watched that would hit 20 different news or media platforms a day. They were saying the same exact thing, word for word. It was all coming down from on high. It was all structured and it was all designed for a particular reason, and the reason was not to make you feel better. I guarantee you that. So don’t trust it. Don’t turn it on. Don’t bother.  There’s a direct correlation between the use of social media and the increase in anxiety.  Don’t put yourself at risk. 

Other risk factors for anxiety and depression would include too much alcohol use and too much junk food that cause gut inflammation. So I’m going to talk again about gut and inflammation, including leaky gut, food sensitivities and microbiome disorders.  However, I’m not going to go into great detail about these because I’m going to do a separate presentation on leaky gut and food sensitivities. Rather, In this presentation, I’m going to talk more about what you can do about anxiety, short term, and testing that can be done for anxiety.  Then, in one or two weeks, we’ll discuss leaky gut and food sensitivity issues in greater detail. 


The Neurotransmitter Paradigm:
Ron Grisanti is the president and CEO of Functional Medicine University, one of the leading universities that offer certification in functional medicine.  Grisanti says, “Unfortunately, it may just be possible that the neurotransmitter paradigm is simply antiquated and does not address the underlying root causes of these mental disorders.” “Neurotransmitter paradigm” what’s he talking about?  He says, “After reading and researching, doing a deep dive into possible root causes of these mental disorders, I found something amazing and life changing.”

So what he’s pointing to is that the prevailing theory that most doctors are working from is that it’s all about a few neurotransmitters. If we could just give you more serotonin, you’d feel good. Well, mostly those SSRI’s or selective serotonin reuptake inhibitors do not test out better than placebo. There are many herbs that test out way ahead of those.


SSRI’s:  An Occasional solution for an occasional Problem
There are certain nutritional substances that test way ahead of SSRIs and with anxiety. We just have to calm you down, give you some benzodiazepines. Okay. Well, tons of side effects there. Maybe it’s all wrong, right? They just made it up and then created drugs to treat it that are not very effective. So we’ve got things like Zoloft, Lexapro, Prozac, etc. and then we have the benzodiazepines Ativan, Xanax, Valium, Klonopin, and many of those are actually even hard to get a prescription for anymore Ativan and Xanax, which I think is unfortunate because for short term use, like you’re going to take an airplane flight.  In fact I’ll have people call me and say, “Hey, do you treat anxiety?” And I’ll say, “Well, heck yeah!  It’s the number one thing we treat in Chinese medicine.” Then they’ll say, “Oh, okay, well, I think I’ll come see you.”  Before I let them go, I’ll ask, “Do you have anxiety regularly?” Their response, “No, only when I’m going to fly.” “How many times do you fly?” I’ll ask.  They’ll usually tell me they fly something like two or three times a year.  Then I’ll send them to get a prescription for Ativan.  Two or three times a year isn’t going to hurt them. It’s inexpensive, it’s effective.  They don’t need to come see me for anxiety they usually don’t have. However, long term use, or regular use is very, very dangerous.

Dr. Grisanti continues, “What I discovered was while nutrient deficiencies do play a role, the major eyeopener was the fact that depression, anxiety and other mental disorders are largely inflammatory in nature.” Now, I’ve got to tell you, there are good studies going back into the 1950s that were done using beef-vitamin therapies that were incredibly effective.  They were also doing other nutrient therapies that were extremely effective. So this is it’s not new. It’s just becoming better understood and the word is getting out.


CYTOKINE STORMS: The Healing Inflammatory Process Run Amok 

In the brain of people that are suffering from depression, anxiety and other health challenges The immune system is activated and there are clearly elevated levels of what are called inflammatory cytokines such as interleukin six and tumor necrosis factor alpha. Fortunately, it’s now much easier and more cost effective to test for those issues, both directly and indirectly. There are tons of tests that can be done. Now, cytokine is a very general term used for small, secreted proteins that are modulators of inflammation. Now, inflammation is critical. You would die with no inflammation. Inflammation is the healing process. You get a cut on your hand, it gets red. You get scar tissue formation. You get a first get a scab. Well, those are all indicators of different forms of the inflammatory process. So the body sends out signals, cytokines to attract other inflammatory chemicals that actually are utilized in the healing process. Then when the healing process is complete, that should shut down again.

It’s important to note that in some people it doesn’t shut down and other people that just run amuck in the first place. So these cytokines are a blessing yet they can also be a curse. And so these are produced in response to pathogens that are invading. They can be in your gut. They can be through your nose. They can be on your skin. What we need to know is that it is a production of cytokines intended to to stimulate, to recruit and cause proliferation or growth of immune cells. As a result, these cytokines must include the interleukins chemokines, interferons and tumor necrosis factor, usually TNF Alpha. We’re not going to go into great depth about any of those. That’s really a biochemistry class or a high-level immune class. But I just wanted to clarify our terms a little bit. So, that’s a simple cytokine map.

I was once doing a seminar down south, and it was mostly functional medical doctors.  The guy who wrote the book on inflammation and heart disease did a presentation. He pretty much got laughed out of his position for saying that the real problem with heart disease is not cholesterol, he said. It’s such a minor problem, it’s almost not worth considering. It’s all about the inflammatory process. And he proved it very clearly. But he put a chart up on the screen like this. But there were about 200 pieces to the chart. It was just mind blowing. So as soon as you memorize this we’ll move on a little bit. But basically, this is kind of fun to look at sometime because you can see some of the correlations here, but it’s way beyond what we’re going to do today.

Here’s the little simpler look. You can’t really see it up here, but this is a pathogen that’s penetrated the tissue. This is a an allergen that’s penetrated the tissue. Here it’s caused an infection. Here it’s caused a mast cell problem. This would be an allergy or a histamine production problem. Sp you get an infection that comes in and activates all of these immune cells to to help heal. They also suppress some of the stuff that could, otherwise, stop that healing process.  Eventually, if it doesn’t calm down, you get systemic inflammation like the majority, the gross majority of patients in the United States have got inflammation which is is very easy to test for. There are tons of these tests a person can look for to find out if he/she is dealing with inflammation. 


Ibuprofen and Gluten positive correlation to Leaky Gut
There was a study done about ten years ago wherein they took a general population that didn’t touch nonsteroidal anti-inflammatory drugs. The drug they happened to look at was Ibuprofen. But I don’t want to give ibuprofen a particularly bad name. Of the general population, about 10% had identifiable and provable leaky gut syndrome.  However, 70% of the people that used ibuprofen once or twice a week, 70%, Had clear indications of leaky gut; hat’s huge! How many people in our culture never use any of those drugs? It’s not an encouraging number. And plus, then what we eat causes inflammation. Food allergies cause inflammation. Yeast causes inflammation in the gut. They all lead to leaky gut. Doctor Alessio, who’s the expert on Leaky Gut, published a paper showing that every single time. Not 90%, not 95%, 100% of the time that any human being eats gluten, they get transitory, leaky gut. That means for some period of time after they eat the gluten, they have leaky gut. Now, the issue is that if you eat other foods at the same time or around that same time after the leaky gut kicks in, you’re liable to develop food allergies to those foods and liable to exacerbate the leaky gut initiated by eating gluten. Now, if you already have leaky gut and you eat the gluten, then you’re toast. It’s just going to set your gut on fire. Okay.


lactobacillus rhamnosus
Now, one of the thoughts by Dr. Grisanti is that, while it’s well known that those psychiatric medications actually don’t do a lot to balance the neurotransmitters, they do help reduce the inflammation in the brain. Maybe, he hypotheses, that’s what allows them to get the meager amount of benefit that they do have. But, irrespective of what those meds do or don’t accomplish, we don’t really have to look past the gut. Once gut inflammation takes hold, those cytokines start circulating through the body and also get into the brain and cause massive, massive inflammation. The secret to reducing that GI inflammation is to identify any food irritants, any bacterial pathogens and improve optimal microbial flora. Some studies have found that just simply using lactobacillus rhamnosus has some promising effects on improving microbial flora and reducing anxiety. Now, I would never even dream of stopping at that one probiotic when there are so many others that are so beneficial and so many other things. But the study showed that just that can help reduce anxiety.


Drugs are needed but are Overprescribed
So there’s tons of studies out there showing that anyone with anxiety, depression, in fact any mental disorder, OCD … ADHD for sure. I’ve treated tons of patients with ADHD and only two of my patients or maybe three have ended up on drugs.  One because he was a too picky of an eater. With another as soon as I talked to the kid, I said, you know, you should go back to your psychiatrist, you probably need those drugs. But out of the dozens, hundreds, actually, of other kids I’ve seen, we were able to get rid of their ADHD, control their problems through lifestyle and dietary changes alone.


Anxiety: Sign of Vitality or Illness
Okay. So let’s take a look at anxiety now. Everybody gets a little worried. I don’t know about everybody. You know, there are few Zen masters out there that probably don’t get anxious, ever. But most of us experience a certain amount of nervous apprehension when you have a stressful situation. However, what we’re talking about is when it becomes excessive or very important, prolonged. So if you have a you know, you’re going to do a talk in front of 500 people and you have a couple of days of anxiety, fine. Does it go away when you’re at the cocktail party after? If it doesn’t, that’s a problem. It also becomes a problem if it interferes with performing your daily activities. That’s when you cross the road from simple worry to a full-fledged illness and you need to treat it. More than 19 million Americans are suffering from anxiety disorders. Actually, that’s a very old number it’s now much higher, particularly when you realize that 25% of the population. So that’s getting us closer to 70 million people at least.


Symptoms of Anxiety Simply Alive or Actually Sick?
Often you get people that think they’re going to die at any moment, even when there’s nothing fearful going on, or there’s this sense of impending doom. They go to the emergency room thinking they’re having a heart attack and all the tests come back that, Hey, there’s nothing wrong. They are told to have an Ambien to go to sleep or have a Xanax to calm down, right? But it keeps coming back and it keeps coming back and they keep going to their doctors saying, look, there must be something wrong with me. Unfortunately, the person with Anxiety, they’re not satisfied, obviously, who would be. And they know that something’s been overlooked. So the Doctor runs more tests only to once again find nothing wrong. And after a while, their family and friends begin to label them a hypochondriac. “It must all be in your mind.” they say. Well, in a way it is, but not in the way they mean. Those friends and family are incorrect. Anxiety almost always has a physiological cause, and it’s just a matter of finding that cause and remediating it, And the anxiety will get better. Many of the things we think our outlet patterns were developed at a very, very early age and they’re really burned in. And those are hard to change. However, once you change that, it’s like a chicken and egg, right? When someone’s under anxiety for a long period of time, then their anxiety response time gets shorter and shorter. And so if you can stop the anxiety response or slow it down a little bit, that gives the physiology a better chance to catch up and to get out of that cycle.

Those are just a few signs and symptoms of anxiety. You can have only one of these and have severe anxiety. But if you’ve got a bunch of them, you got a problem. Okay. Trouble falling or staying asleep? You know, the Romans, if someone had insomnia, they were considered to be a bad person. They said you can’t have insomnia unless you’re really, really afraid of something and you’re over thinking and you must be a bad person. Okay, now shortness of breath, diarrhea, you name it. Headaches are often from anxiety because it changes your neurotransmitters. It causes more muscle tension, which definitely changes your blood flow. So these are all common symptoms of anxiety. My patient today had about 90% of them.


Fight or Flight mode is bad for the gut
When you feel anxious, your body releases hormones that prepare you to react to a threat. That’s called fight or flight. It’s actually called fight, flight or freeze. Some animals and some people will literally freeze. Cortisol activates your blood sugar, so you are using tons of blood sugar. Epinephrine makes your heartbeat really fast moving oxygenated blood to the muscles that are going to be needing it the most. Norepinephrine pulls the blood out of the center, out of your organs, your ovaries, your stomach, etc., and puts the blood into your brain and into your hands and feet, etc., so that you can run away from the tiger. But while you’re running away from the tiger, you’re not digesting your food, you’re not building a good egg in the ovary, etc. It’s one of the primary causes, of infertility. When a woman comes to me with unexplained infertility. My first thought is anxiety and stress, and I’m almost always correct. Once I start doing some testing in the clinic and then also order some blood tests and urine tests that you will see this elevated fight or flight response, which is preventing them from getting pregnant.


The Adrenals They’re Talking, Who’s Listening
Now I’m going to talk a little bit about clinical lab assessments. And some of these following tests that I’m going to go over with are the tests that should be done for anxiety and unfortunately, rarely are done for anxiety. So adrenal stress and cortisol, this can be a blood test. It’s usually done as a saliva test because to be accurate, you need to do cortisol test several times a day and it’s not very convenient to do a plasma or serum cortisol. So we do saliva generally for that. We can do urine testing, which will show a lot of accuracy also. And this will show imbalance in what’s called the HPA axis, or the hypothalamic pituitary adrenal axis. Now, you have to remember that almost all maybe all hormonal responses in the body are feedback responses, right? So the body, there’s the hormone secreted. It’s being noticed. It’s being noted in the hypothalamus, which is saying, okay, that’s the right amount, or it’s too low or it’s too high and it sends a message to a closed circuit message to the pituitary gland that sends out one of the stimulating or trophic hormones, thyroid stimulating hormone, adrenal cortical hormones, follicle stimulating hormone, etc.. That pituitary gland will send out a message to either slow down or speed up the activity. One of those axes is the adrenal axis. So it’ll send messages just to the adrenal gland.  Create more corticosteroids; create more aldosterone to control sodium, potassium levels or, put the cortisol in check, etc..


“Captain, the Thrusters Aren’t Responding! I can’t stop her.”
Now, over time, those feedback loops can be damaged. So if someone is under stress all of the time, at some point the system can break down and it’s like, Oh God, this person’s always at stress. That must be the necessary level of hormone. And so the pituitary sends out too many signals all of the time. So even when you’re no longer anxious, you’re still sending signals to release more hormones. MD’s almost never check for these issues. I have been laughed at many times by conventional medical doctors when I’m talking about adrenal issues. Functional medical doctors will always check for these, they’re at the top of their list, but MDs, no.  I’ve been checking these for years. These are not particularly expensive.  Again, plasma is unlikely to be used.  If it is, it’s going to be expensive because we’re testing for different markers.  If we’re testing for common adrenal issues, we can use the saliva test which is relatively inexpensive and very easy to administer. You spit in a little tube. It’s really not all that hard.


The proverbial needle in the Haystack: Use A Magnet Okay
The thyroid panel. Now, your doctor will run a test stage, which can be very, very misleading. There are 27 identifiable forms of hypothyroid. That’s not even including hyper thyroid. 27 identifiable forms! But you have to run the right tests to find them. If you don’t look for them, you ain’t gonna find ’em. And there’s a high correlation between certain thyroid laboratory values and anxiety. This can be a plasma, a blood test, it can be a urine test or it can be a saliva test. Any of those can work. You just have to know how to interpret the values for each one of those. MDs rarely check for thyroid antibodies, and it’s when you have the thyroid antibodies or you have hyperthyroid, in which case you’ll also generally have thyroid antibodies, that would that you see anxiety is very common. In fact, almost everybody in a hyperthyroid state, has anxiety.


2nd Hand News, Cortisol handcuffs, treating all the malaise indicated.
Okay. So the assessment of thyroid hormone production. Peripheral conversion, the thyroid hormone has to go through conversion. So the hypothalamus is reading the labels all the time. It’s talking to the pituitary. And if it says, hey, we need more thyroid hormone, it sends a jolt of TSH thyroid stimulating hormone. So when your doctor checks your TSH, they are actually not testing your thyroid directly. It is not a thyroid hormone. It’s the thyroid stimulating hormone. So then the. Thyroid creates several different forms of thyroid hormone. Basically T-1, T-2, T-3 and T-4. About 90% of it’s T4 and T4 is released into your system. That’s four iodine molecules bound together by tyrosine. And it doesn’t do much. It just kind of mostly floats through your system. Then, when you need energy, that converts to T3. So it breaks off an iodine molecule to become T3 and that’s where you get the peripheral hormone conversion it converts from T4 to T3.  However, a problem can occur when Cortisol binds with T4 and prevents it from converting to T3 properly. Uh Oh!  Also, it causes the release of something called Reversed T3.  Reversed T3 tricks the body into thinking you have enough T3 but it only has about 10% of the activity. So with those unexplained fertility patients, they almost always have high reverse T3 and high cortisol. So they’re not converting to T3. And that’s why last study I saw 56% of thyroid patients when given T3 along with T4 felt better than if they took T4 alone because part of their problem was conversion.  Then you’ve got to verify the cellular sensitivity response: Once you’ve got the T3, is it triggering what it’s supposed to trigger? And the receptors are then we want to measure thyroid hormone antibody activity, because if you have antibodies to your own T4 or to your own thyroid peroxidase, which is an enzyme needed to produce thyroid hormone, then we got a whole different ballgame.


The Organic Acids Test:  The New Swiss Army Knife:
Now if your MD does test for those and they’ve found that you have high TPO or Thyroglobulin antibody problems, they treat that the same as if you just have a low thyroid. Well, we don’t, we treat the thyroid hormone, but we also know that we need to get your thyroid gland not to be on fire anymore. By the way, the number one stimulator of high TPO, by far. More important than everything else put together is gluten. I’ve had patients go from a TPO level of 1200 down to 120 in six weeks by stopping gluten. So it’s huge. So anyway, we put all those different things together and we figure out what’s actually going wrong with your thyroid, and that can have a huge role in anxiety. Then allergy and food sensitivity. We’re talking about the gut. And so you’re going to have allergic responses really to anything, right? But foods, very common inhalants, environmental chemicals, etc. Screening now is very, very easy for this. You can do it with just a blood spot, one spot of blood, sometimes two spots of blood to do a ton of testing, looking for food allergy responses. Again, the prices on all of these tests are coming down. There are actually quite affordable now. Organic acids testing. So this is a urine test and this doesn’t test directly for problems. It tests indirectly for them. Right. And so we see how the body responds and what markers, what biomarkers or biochemical intermediates are in the urine. Then we can see if you’re processing dopamine. Do you have enough dopamine? Are you processing it properly? Are you creating and utilizing too much epinephrine? Are you creating too much norepinephrine? How’s your serotonin level? Do you have a high exposure to molds? Do you have a high exposure to bad bacteria in your gut? Do you have a high exposure to even worse bacteria in your gut? You have a high exposure to yeast in your gut, etc. and that actually will tell us a lot about what’s happening in the actual energy cycle, the Krebs cycle. It’s amazing when you start to see all of the things that start to show up there. So amino acid levels, nutrient cofactors minerals, fatty acids, it’s an astonishing test an organic acid test, relatively new, relatively inexpensive.


Vanilmandelic and homovanillic
Just looking at these two acid tests here, vanilmandelic and homovanillic. Each Will tell you about Norepinephrine, elevation and Norepinephrine and epinephrine. Each have their precursor as dopamine. So if you are using too much norepinephrine, too much epinephrine, you’re going to have diminished stores of dopamine. If you have diminished stores of dopamine. You’re going to be anxious and or depressed and you won’t want to do anything. You won’t want to get off the couch. Right? If you have low dopamine, nothing is fun anymore. Life is kind of a drudgery and that’s often low dopamine. Then we see these high levels of neurotransmitters associated with the inability to manage stress. In this particular organic acid tests that we generally run, there are 76 different biomarkers present. It shows a lot.


And another one in the organic acid testing is Pyroluria. And I’ve only seen one doctor ever test for this, but it’s a very, very common problem for anxiety. You also see it in a lot of mental emotional disorders and in this one alcohol treatment center, one third to one half of alcoholics have this marker. It’s high and high levels of Pyroles bind to B6 and zinc preventing their use in the body, specifically in the brain. And B6 and zinc are two of the most important, most important things in the body to provide energy. And so here you get a myriad of symptoms. You get cardiovascular problems, attention, anxiety, poor stress control, total fearfulness and some episodic anger.


Okay. That’s as far as we’re going to go today. I want to cut this one a little bit shorter, but that gets us kind of I wanted to I wanted to show you that there is a problem that is very common beyond what you’ve been told is a problem, and also that there are tests for all of these. And once you do identify the problem with the testing, there are treatments for all of them and many of them are obscenely simple treatments. All right. So that’s it for today. I will be back next Tuesday at 3:00. And I should be on time next time because I don’t have another webinar before. And we’re going to go into some really, really fun stuff. So I want to thank you for tuning in. Send us some questions. I love what you’ve been doing so far. Be happy. Be healthy.

Dr. John Nieters L.Ac, DAOM, is an acupuncturist, Chinese herbalist, functional medicine, writer, teacher, and leader in the community. In this episode, John talks about his experience with the importance of finding your vision and purpose in life, in order to create the right goals for you.

Disclaimer: Dr. John Nieters received his Doctor of Oriental Medicine and Acupuncture degree from Five Branches. His use of “doctor” or “Dr.” in relation to himself solely refers to that degree. Dr. Nieters is a licensed acupuncturist in California. This video is for general informational purposes only. It should not be used to self-diagnose and it is not a substitute for a medical exam, cure, treatment, diagnosis, and prescription or recommendation. It does not create a doctor-patient relationship between Dr. Nieters and you. You should not make any change in your health regimen or diet before first consulting a physician and obtaining a medical exam, diagnosis, and recommendation. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. TheBalancingPoint.net, Alameda Acupuncture, and Dr. John Nieters L.Ac, DAOM are not liable or responsible for any advice, course of treatment, diagnosis or any other information, services or product you obtain through this video or site.

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