Natural treatments for Anxiety.

IS ANXIETY A FACT OF LIFE? I don't think so. Readers have requested we address the subject of relieving anxiety by using the amino acids Taurine, & GABA, and Vitamin B3 (Niacin). Though setting out to do this, by the time anxiety & taurine were finished, the news was too long, so GABA & B3 will have to wait. Taurine has many other benefits, so if anxiety is not your interest you may want to skip ahead to the Taurine section. I would not begin helping someone with anxiety by giving these single agents alone, & indeed they may not need to be given. Suffice it to say, when you are physically healthy & biochemically balanced you should have no symptoms of anxiety unless you find yourself in an extremely emergent situation. Those under 18 or over 38 who suddenly develop anxiety which disrupts their normal activity may have one of the medical illnesses which can include anxiety & should have appropriate medical evaluation. Apparently, many in our society are anxious because minor tranquilizers are one of the most widely prescribed group of drugs & among the most problematic when regularly used long term, which, unfortunately, they often are. They are highly addicting & over time risk adding to the very symptoms they were originally intended to alleviate. Though the Physicians Desk Reference warns of their addictive potential & suggests only intermittent or short term usage, these warnings are often ignored. Some of these tranquilizers are Xanax, Klonopin, Ativan, Valium, Librium. Tranxene, as well as some of the sleeping meds. PHYSIOLOGICAL OR PSYCHOLOGICAL ANXIETY, OR BOTH? It helps to distinguish whether the anxiety begins with physical symptoms such as racing heart, sweaty palms, shaking, nervous stomach, restlessness, tension, etc. & then perhaps spreads to associated thoughts & fears. Or does it begin with fearful anxious thoughts & spread to become a physiological reaction? Or is it only manifested by thoughts with no physical component or physical symptoms with little associated fear thoughts. When there is a usual thought onset to the symptoms, besides doing all of the next recommended items, it is important to decondition your thought patterns. There are many techniques for doing this. My current favorite is the use of Hypnoperipheral Processing reprogramming tapes. This is a combination of hypnosis & Neurolinguistic Programming. It is a powerful & effective tool for change! You can find such tapes at http://www.metamodels.com/maps/hpp.html. I would suggest the series "Changing Emotions" & "Feeling Better". We also clarify the timing of the anxiety. Is it all the time, or at certain times of the day or night? Is it only in very specific situations? I had a patient who only had severe anxiety when going out in the car. We found she was sensitive to auto fumes & when we had her wear a carbon filtered mask to keep out the fumes, she was able to go out without any anxiety. What percentage of agoraphobics are having their symptoms as a reaction to a specific chemical environment? All of this detective work helps to clarify how much is physical, how much is psychological, or even how much is a psychological conditioned response to a physical trigger. Is the problem related to blood sugar instabilty, which I see quite often & commonly has a pattern of middle of the night, early a.m. or mid-afternoon symptoms. Or is it related to food sensitivities? Is there is a personal or family history of allergies or is a person repetitively eating the same foods, or many of the high allergen foods, such as milk, cheese, wheat, eggs? We also look for a history of high caffeine, alcohol, or sugar intake , or a general junk food diet. Is there a premenstrual or menopausal component? Is the person on medications which can cause anxiety as a side effect? WHAT DOES NUTRITION HAVE TO DO WITH ANXIETY? It is known that deficiencies of certain nutrients can cause anxiety, so begin by improving your diet. Those nutrients are: Vitamins B1, B3, B6, B12, folic acid, calcium, magnesium, phosphorus, omega-3-fatty acids, such as fish or flax seed oil, & certain amino acids, such as L-tryptophan, taurine, GABA. Too much calcium can also cause anxiety. First, clean up your diet. With your diet improvement you may want to add a good multivitamin mineral, an extra B complex, & an omega-3-fatty acid to basically cover most of the above listed nutrients. You would then only add extra items if all of the above failed to make a difference after 2 weeks. My first choice would be extra magnesium & the next choice would be taurine. WHAT IS TAURINE? Taurine is an amino acid which plays a major role in the brain as an "inhibitory" neurotransmitter & neuromodulator. It is similiar in structure to the amino acids GABA & L-Glycine, which are also neuroinhibitory. This means it helps to calm or stabilize an excited brain. Taurine stabilizes nerve cell membranes thus depressing the firing of brain cells & dampening the nerve cell action of the excitatory amino acids, glutamate, aspartate, & quinolinate. Taurine acts by regulating the sodium & potassium concentration in the cells & the magnesium level between the cells. This has everything to do with the electrical activity of the cells & subsequent communication between cells. By this mechanism, it has anti-anxiety & anti-convulsant activity. It has also been found useful in some cases of migraine, insomnia, agitation, restlessness, irritability, alcoholism, obsessions, depression, hypomania/mania. Dosage is from 500 mg twice daily to a total of 5000 mg daily in 3-4 divided doses, though I rarely recommend that high a dose. The total ideal body pool of taurine for adults is 12,000- 18,000 mg. Since taurine also affects the hypothalamus to help regulate body temperature, a higher dose can decrease your temperature & give chilliness, so be aware of that. Taurine also plays a role in memory & increases the level of a memory neurotransmitter, acetylcholine, in the brain (in animal studies). HOW DO YOU GET TAURINE? Taurine is highly concentrated in animal & fish protein or organ meats. Strict vegetarians can be at risk for taurine deficiency. Your body can make taurine in the liver & brain from the amino acids, L-Cysteine, & L-Methionine. Three enzymes are involved in the conversion, all requiring the pyridoxal-5-phosphate form of Vitamin B6 for this conversion. A B6 deficiency can thus cause a taurine deficiency. Some studies suggest humans are dependent upon dietary taurine to maintain "adequate" taurine reserves. Females tend toward lower taurine levels than males as their production pathways don't work as efficiently. Taurine is closely bound to zinc & manganese so deficiencies of either of these can interfere with its' utilization. Likewise, zinc & manganese enhance the effects of taurine. Taurine is the amino acid present in highest concentration of all amino acids in the fetal & newborn brain, which is the most dependent upon taurine & the least able to synthesize it.. The developing infant must derive taurine from the placenta, the newborn, from breast milk or taurine fortified formula. It is low in cow's milk. Taurine is essential for proper development of the central nervous system & the eyes. Nursing mothers especially need taurine as it stimulates prolactin to promote lactation, which is an interesting twist of nature, since infants need it so much. ( We could speculate that a mother unable to lactate may be taurine deficient, among other possibilites, & the infant is thus protected from receiving taurine deficient breast milk) Premature infants are especially prone to taurine deficiency. WHAT ELSE INFLUENCES TAURINE LEVELS? MSG can decrease taurine. Trauma, surgery, radiation therapy, burns, muscle diseases, steroid use, intestinal dysfunction with bacterial overgrowth of the small bowel can all lead to excess loss of taurine in the urine & subsequent deficiency. The medications Thorazine (a major tranquilizer) & Chloroquine (an antimalarial) can reduce taurine levels. Some depressed patients have decreased taurine. WHAT ELSE DOES TAURINE DO? EYES: It is in high concentration in the eyes where it has multiple functions to maintain normal retinal structure & function. Depletion leads to degeneration of the photoreceptor cells. Degenerative changes in the retinas of taurine deficient cats & dogs resemble retinitis pigmentosa. Taurine may be helpful in preventing cataracts. Age related macular degeneration has responded favorably to "injected" taurine as reported by American Biologics Mexico Hospital. CARDIOVASCULAR: Taurine is the most abundant amino acid in the heart, a particularly electrically excitable tissue, as are the brain & eye. Since taurine participates in electrical stabilization of the cell membranes & the normal regulation of nerve-muscle interaction, it is useful in heart irregularities & mitral valve prolapse, acting similarly to a calcium channel blocker (a class of drugs used in CV Disease) Taurine also helps control high blood pressure & is useful in congestive heart failure. DIABETES: Taurine affects carbohydrate metabolism. It potentiates the effect of insulin, enhances glucose utilization & glycogen (stored glucose) synthesis. FAT METABOLISM: Taurine reduces cholesterol by forming bile acids which are the end products of cholesterol breakdown & are the only route for eliminating cholesterol from the body. This action requires a functioning gall bladder. Taurine has an inhibitory effect on the formation of cholesterol gall stones. It is required for efficient fat absorption & solubilization. It is helpful in states of fat malabsorption such as with cystic fibrosis & other pancreatic deficiency syndromes. DETOXIFICATION: Taurine conjugates & detoxifies various internal & external toxic compounds & may help chemical sensitivities. ANTIOXIDANT: Taurine plays a major role in protecting cell membranes from oxidative attack. STRESS: It can inhibit the release of adrenalin & thus help with anxiety in this way, as well as protecting from other adverse effects of too much adrenalin. MISC: Acts as an immune stimulant to increase Natural Killer Cell Activity & Interleukin 2. Controls cell volume & osmolality. Is involved in the regulation of iron metabolism. Modulates levels of serum copper. TAURINE CAN ALSO STIMULATE RELEASE OF STOMACH ACID SO YOU SHOULD AVOID IF YOU HAVE ULCERS OR GASTRITIS. BE HAPPY!! Priscilla Slagle M.D.

GABA Potentiators

Neurosciences Newsletter on GABA GABA is a true neurotransmitter and is involved in many clinical conditions. These include anxiety disorders such as panic attacks, seizure disorders like epilepsy, and numerous other conditions including addiction, headaches, Parkinson's Syndrome, and cognitive impairment. GABA's role is that of the primary inhibitory neurotransmitter and functions by down-regulating neurotransmission. Neurons are electrically charge cells. Ion pumps actively transfer Na+ ions out of the neuron and a overall negative charged known as the cells resting potential is attained. Two opposing forces work to alter the neurons electrical potential. The neurotransmitter glutamate increases the flow of positively charged Na+ ions into the neuron and reduce the neurons electrical charge. If the electrical potential is reduced to a critical point , called the action potential, the neuron will fire. In contrast, the neurotransmitter GABA opposes the effects of glutamate and prevents the neuron from firing. GABA achieves this by effecting the actions of the GABA receptor, a 5 subunit ion transporter. When GABA binds to the GABA receptor, the subunits of the receptor "open" and there is an influx of chloride ions. This influx restores the electrical potential of the neuron and thereby decreases the likelihood that the neuron will depolarize and relay the incoming signal. Essentially, weak or irrelevant signals are more likely to be terminated or "ignored." GABA receptor and the putative binding site for a number of agents that affect GABA function. This diagram shows the GABA-A receptor and the putative binding site for a number of agents that affect GABA function. The GABA receptor is a relatively large molecule and has binding sites not only for GABA but also for many modulatory compounds. Many of these modulatory compounds are useful therapeutic agents. Positive GABA modulators, like the benzodiazepines, do not cause the ion channel to open and an influx of chloride ions to occur on their own. They only enhance the activity of naturally occurring GABA by potentiating its function and therefore have vastly reduced potential for overdose or side effects than receptor agonist compounds, like barbiturates. While much safer than barbiturates benzodiazepine use frequently leads to dependence and withdrawal syndrome effects. This limits their utility for mild/moderate symptoms as well as for long-term therapy. Because of the important role for GABA and positive GABA modulators NeuroScience has developed a number of products that address GABA and are beneficial for patients with GABA related disorders. The following ingredients have been found to increase GABA or have a positive GABA modulating effect and have been combined in specific amounts and ratios depending on the results of laboratory tests and the clinical application. Taurine Taurine is an amino acid that is present at significant levels in the CNS and is positive modulator of GABA that does not have any adverse side-effects. Taurine also potentiates glycine - the inhibitory neurotransmitter in the spinal cord. The role of taurine as an inhibitory amino acid has been confirmed in many studies. Not surprisingly, brain tissue and cardiac tissue, which are susceptible to high levels of neurotransmitter stimulation, maintain high levels of taurine. Taurine has been shown to prevent the neuronal damage that can occur when there is an exposure to increased levels of the excitatory neurotransmitter glutamate. Over stimulation by excitatory neurotransmitters is the primary cause of neuron death in ischemic stroke. Taurine has been found to significantly reduce neuron death caused by over stimulation. The calming effects of taurine have been well studied. Other studies of taurine have found that it can reduce epileptic seizures and that low taurine levels are associated with anxiety. Glutamine Significant quantities of glutamine are normally present in the brain to support the complex process of GABA synthesis. Glutamine is an amino acid and a common precursor for the biosynthesis of GABA and glutamate. Glutamine is transported into the presynaptic terminals of inhibitory neurons by the glutamine transporter (GlnT) and is catalyzed by the actions of the enzyme glutamine deaminase to form glutamate. Glutamate in turn is converted into GABA through the actions of glutamic acid decarboxylase (GAD). (NOTE: This biosynthetic route is somewhat more complex than originally thought. Some studies have demonstrated that the glutamate formed from glutamine may enter the tricarboxylic acid (TCA) cycle before being converted to GABA.) 5-HTP Serotonin is a neurotransmitter, or more correctly a neuromodulator, that is widely distributed throughout the brain and generally enhances GABA and therefore has inhibitory activity. Therefore, as a precursor to serotonin, 5-HTP can further increase the activity of GABA. Low serotonin levels are frequently an underlying component of many clinical conditions that are also related to GABA function, e.g. insomnia, depression, & anxiety. Neurotransmitter tests show that GABA needs serotonin to function properly. Normally, GABA increases and acts through a negative feedback mechanism to reduce elevated excitatory neurotransmitters. However, this feedback mechanism requires the neuromodulating effects of serotonin. This is evident in patients with symptoms related to low GABA who have adequate GABA levels but low serotonin. Theanine Theanine is another amino acid that affects GABA. Initial interest in theanine arose due to the seemingly paradoxical calming effect of a caffeine containing drink. Theanine is a naturally occurring amino acid present at significant levels in tea leaves and is the component responsible for this discord. Theanine has been found to alter glutamate transport and actually increase GABA levels. Further studies reveal that theanine reduces hypertension in models of hypertension, increases the effectiveness of some chemotherapy compounds, reduces the stimulatory effect of caffeine, and calms patients.