by Ali Miller
Adaptogenic herbs, when sourced from a company that tests for mold, contamination, potency and purity, and organically grown or wild sourced where possible, provide active influence on supporting balanced mind and memory while improving cognitive function and reducing anxiety. Use adaptogens as a tool to prevent HPA-axis imbalance or to manage it with additional formulas as needed. Pair them with lifestyle support discussed in Chapter 8 for optimal outcomes. These herbs can be consumed in tea, tincture, or pill form and should be a first line of defense for stress, aiding in your ability to adapt to whatever life throws at you with ease.
Adaptogen formulas include ashwagandha, panax ginseng, rhodiola, cordyceps, eleuthero, schisandra, maca, tulsi (holy basil), astragalus, and licorice root.
Nervines to Help You Find Your Mellow
Nervines are a group of traditional herbs that support healthy nervous system response, reducing excitatory activity and protecting nerve function. They can have a physiological influence on the central nervous system, with nerve and muscle relaxation, as seen with skullcap, or nourishing influences. Oat tops protect nerves from damage and aid in caffeine withdrawal. Mentally, the effects of nervines can range from mild anti-anxiety influence, as seen with oat tops and chamomile; to moderate effects of lemon balm and passion flower, which reduce tension and restlessness; to the level of sedative effects seen with valerian and poppy.
Nervine formulas include oat tops (Avena sativa), chamomile, catnip, passion flower, lemon balm, lavender, hops, skullcap, valerian, poppy.
Recommended Supplements
I use the following formulas in clinic to aid in rebounding from adrenal fatigue and balancing the HPA-axis.
Adaptogen blend/Adaptogen Boost: See page 165
Adrenal glandular: When an individual has suboptimal cortisol along with low adrenal output overall, a glandular compound is often warranted. A glandular is an animal gland that is desiccated but retains its bioactive properties. Adrenal glandular is typically derived from cows. It is important to look for a product that is third-party assessed for purity as well as toxicity.
Nervine and adaptogen blend with L-theanine/Calm and Clear: See page 165
High-dose vitamin C: Promotes healthy adrenal output and reduces stress impact to the body. The adrenals are the highest concentrated storage of vitamin C in the body and they use it in production and management of cortisol. Start with 2–3 grams per day as a base dosage and look for a form that is buffered to aid in absorption and reduce GI distress. Dosages upwards of 5–10 grams may be warranted in individuals experiencing immune distress and low platelet count.
Sleep Support: A blend of tonifying nervines with sedative nervines and melatonin, this Naturally Nourished formula is a safe, effective alternative to sleeping medications. It supports relaxation and reduced tension while promoting a restful night of sleep and generalized state of calm.
Note: If dealing with low serotonin levels, melatonin may be needed for a period of time as your production increases, as serotonin is manufactured from melatonin.
FOOD AS MEDICINE
Rebound Your Adrenal Glands
Nutritional support for adrenals and HPA -axis in the anti-anxiety diet program includes rich sources of B vitamins to rebound the gland, including animal proteins, leafy greens, and avocado; and magnesium for relaxation of muscles, improved sleep, and cortisol metabolism. The recipes in this chapter also feature vitamin C to boost immune system and fight brain cell damage from prolonged cortisol hormone exposure. You will also get to experience consumption of adaptogens in the steamer and nutball caramels, helping you rock through your day feeling resilient.
Anti-Inflammatory Electrolyte Elixir, page 108
Stress-Stabilizing Steamer, page 109
Citrus Burst Smoothie, page 112
Roasted Colored Peppers, page 122
Walnut Maca Caramels, page 147
Turmeric Orange Gummies, page 148
Matcha Coconut Gummies, page 149
CHAPTER 7
Rebalance Your Neurotransmitters
I want to close my 6 Foundational Rs of anti-anxiety with the most direct system for mood stability and anti-anxiety effects, the neurotransmitters. Remember, when the gut is inflamed and the HPA-axis is imbalanced, this often causes imbalance or depletion of neurotransmitters, leading to anxiety, agitation, panic, and chronic distress.
Traditional approaches to regulate mood and reduce anxiety focus on the imbalance of neurotransmitters. In fact, the pharmaceutical industry brings in over 15 billion dollars per year in antidepressant and anti-anxiety drugs targeting neurotransmitter function. Topping the list of these drugs are reuptake inhibiting drugs that perpetuate selective neurotransmitter signals. Selective serotonin reuptake inhibitor (SSRI) medications, along with a newer class of drugs that target the adrenal neurotransmitter norepinephrine, selective serotonin norepinephrine reuptake inhibitor (SNRI), are used on millions of people. However, 30–50 percent of this population suffers from drug side effects. Unfortunately, these drugs do not increase the stores of the neurotransmitters; they simply recycle the already low neurotransmitters, which can often lead to even lower production, driving more symptoms and mood instability.
Rather, a person can use food as medicine, as well as targeted nutrient supplemental support, to balance or replete neurotransmitters.
What Are Neurotransmitters?
In simplistic terms, neurotransmitters are chemical messengers that carry signals from one neuron to another. The autonomic nervous system (ANS) is comprised of both the fight-or-flight sympathetic and rest-and-digest parasympathetic systems discussed in the last chapter. It runs through the spine, driving most unconscious activity such as heart rate, respiratory rate, digestion, pupil dilation, and many reflexes. In the craniosacral areas of the spine, the parasympathetic nerves are expressed, and between these regions, in the thoracic lumbar area, the sympathetic stress response is expressed. The ANS communicates through a complex networking system of ports and threads from these spinal regions to peripheral glands of focus and directly to the GI tract. Fibrous nerves carry messages of neurotransmitters to and from the central nervous system, targeting any of the 30 billion neurons in your brain.
Neurons form connections with other neurons known as synapses, and messages cross the synapse from one neuron to another via chemical communication of neurotransmitters. Beyond neurons in your brain, a neurotransmitter can signal and communicate with neurons in the gut and can even communicate with non-neuron cells such as muscle and gland cells.
There are over 100 unique neurotransmitters, which play an integral role in daily function, cognitive processing, and perception. Protein compounds, called amino acids, are the building blocks for creating neurotransmitters, which are combined in the presence of specific enzymes and cofactor nutrients.
The direct neurotransmitters of focus for anxiety are the inhibitory signals serotonin and GABA, which help the mind mellow out and reset following anxiety stimulation. The drivers of distress are the excitatory neurotransmitters, including acetylcholine, epinephrine, norepinephrine, dopamine, and glutamate, which stimulate stress activity and anxiety response.
Anxiety can be seen due to an excess of excitatory neurotransmitters or a deficiency of inhibitory neurotransmitters, or relative dominance and imbalance seen within the symphony of your brain’s expression. If one neurotransmitter plays louder than it should or is overexpressed, or if there are many neurotransmitters playing out of turn, this can throw off the harmony of the brain, causing panic, worry, racing thoughts, or crippling panic. A state of chronic anxiety can drive constant imbalanced neurotransmitters as the anxiety reaction continues to drive demand and further depletion. When there aren’t appropriate conditions to manufacture neurotransmitters due to microbiome imbalance or lacking the building blocks due to deficiency of nutrients, it is difficult to get out of anxiety as a vicious cycle.
What Influences the Expression of Neurotransmitters?
Neurotransm
itters are influenced by production pathways and precursors, or amino-acid building blocks, available. The level of need of a particular neurotransmitter is relative to the demand on which it is needed based on environment and perception of the individual. For instance, an individual who works 10+ hours a day and gets poor sleep is likely running on adrenaline, so they may be burning through or making an excess of epinephrine, and their brain may be trying to balance this surge by spilling out more inhibitory compounds serotonin and GABA. Over time, based on demand and limitations of the building materials, precursor amino acids, and cofactors, imbalance will be seen in symptoms of anxiety, insomnia, difficulty concentrating, brain fog, and more!
Providing building blocks of deficient neurotransmitters is one step in focused support of rebalance; however, activating that production is also essential. Most amino acids or building blocks are able to cross the blood-brain barrier, aiding in production of neurotransmitters. When focused on therapeutic effects, it is important to take supplemental forms of amino acids separately from protein-containing meals. This will help the body absorb neurotransmitter-building amino acids without competition from the amino acids found in foods.
A diet rich in bioavailable protein provides foundational support for ample building blocks or precursors. Although strategic use of amino acids in supplement form should be separated from protein-containing meals to get targeted effects, it is important to note that overall, a low-protein diet very well may drive deficiency of building blocks in general. If an individual is not consuming ample protein, their body will spare the limited amino acids for the varied functions of the body, including metabolic, immune-related, and structural function.
Starting with a low-protein diet limits intake of amino acids, which drives higher susceptibility to depression and anxiety. Selecting wild-caught fish or grass-fed, pasture-raised meats will provide a higher quality source of nutrients without the taxation of pro-inflammatory compounds found in conventional sources. A diet rich in the amino acids tryptophan, tyrosine, and glycine will increase GABA production and have a calming effect. This can be achieved with a diet of amino acids found in clean sources of pasture-raised poultry and pork, grass-fed beef, as well as bone broth, gelatin, and pork skins.
CALCULATE YOUR BODY’S PROTEIN NEEDS
1. Take your body weight in pounds and divide it by 2.2 to convert pounds into kilograms
Weight in pounds _______ / 2.2 = _______ kg
2. Calculate your protein needs at lower range
lower value × weight in kg = _______
3. Calculate your protein needs at higher range (see g of protein per kg body weight below) higher value × weight in kg = _______
4. Plug in numbers for your ideal protein range: _______ – _______ g/day
Recommended Daily Protein Intake Based on Body Weight
If you are within 10 pounds of an ideal weight (see note below), consume 1 to 1.4 g protein per kg of body weight
If you are overweight by 50 pounds or less, consume 0.8 to 1.2 g protein per kg of body weight
If you are overweight by greater than 50 pounds, consume 0.8 to 1.0 g protein per kg of body weight
Lower levels are suggested for overweight individuals based on the assumption of restriction of calories, focusing on feeding ideal body weight to aid in results of weight loss.
Ideal weight is defined as:
106 pounds at 5 feet + 6 pounds per inch for men
100 pounds at 5 feet + 5 pounds per inch for women
If you are under 5 feet tall, subtract 3 pounds per inch.
Please note: I do not use body weight as a primary judge of health. I consider body composition and percent body fat as a stronger indicator of disease risk and optimal health as well as consider various biomarkers that can be seen in people at heavier weights. I am using this “ideal weight” concept to ensure ample protein provided scaled to body size without overconsumption or promotion of a high-protein diet.
As with everything in the body, it is important to focus on ample amounts to prevent depletion and support your needs, but maxing out is not the goal, as more does not translate to better! In fact, a diet that is too high in protein can drive cortisol output, which will drive anxiety and stress response. There seems to be a sweet spot of optimal protein range that works best when accompanied with a diet rich in phytocompounds, antioxidants, and minerals, as seen in your anti-anxiety diet program.
When looking at macronutrient caloric distribution of carbs, protein, and fat, the anti-anxiety diet should be predominantly fat (>50 percent), followed by protein (15 to 30 percent) and moderate carbs (5 to 20 percent). The first phase of your anti-anxiety diet uses the ketogenic approach to teach your body to become fat adapted, coating and protecting your brain and nervous system. This phase should be 70 to 85 percent fat, 15 to 20 percent protein, and 5 to 10 percent carbs. Learn more about the anti-anxiety diet guidelines in the following chapter.
Regulating the physiological demands of stress can help to rebalance your neurotransmitters as well. As noted, if you are burning the candle at both ends, your body will be in a constant state of burn, and you will likely experience more symptoms of imbalance. As I always say to my clients, you can’t out-supplement lifestyle! You have to find a balance at both ends of the equation where you undo deficiency trends and prevent the burnout.
With this being said, many of us are under chronic stress from environmental or emotional drivers that we are not able to modify, such as divorce, death of a loved one, a child struggling, situations at work, etc. In this case, working on perspective and those things you can control may be the most powerful tool, supported by adaptogens and specific nutrients of focus.
Employing deep-breathing techniques such as the 4-7-8 breathing of Dr. Andrew Weil is one way to truly harness the wild stallion in your brain, sending relaxation signals down the vagus nerve from the body to the brain and back. See Chapter 8 in lifestyle support for an explanation on how to follow 4-7-8 breathing. Beyond breath, focusing on sleep hygiene or routine to set up the mind and body for a restful night’s sleep can be a powerful way to reduce anxiety. Research supports that seven to nine hours a night can reset stress hormones and reduce anxiety!
Then, of course, to get you “out of the water” and optimize brain function, the use of amino acids can be beneficial. Studies demonstrate when putting people at an increased state of physiological stress, supplementation with the amino acid tyrosine can aid in mood stability and reduced panic or anxiety.
Beyond deficiency of the building blocks and demands of the neurotransmitters, the receptors that neurotransmitters target may be equally important. Excess stimulants, both in medications such as Adderall and in foods such as caffeine, have been shown to strip the receptors, making them less receptive to neurotransmitters, thus expressing low levels even in abundance of the compound itself.
How to optimize your neurotransmitter levels:
•Eat adequate protein.
•Support utilization and absorption of protein with a digestive enzyme.
•Get seven to nine hours of sleep at night.
•Practice deep breathing and 4-7-8 breathing.
•Adjust environment to reduce stress and learn to say “no.”
•Practice perspective and gratitude.
•Consider amino acid supplementation.
You can find more on the lifestyle application of the anti-anxiety diet program in Chapter 8.
Get to Know Your Neurotransmitters
Let’s meet the primary players in your brain’s symphony of cognition and mood regulation. We will start with the inhibitory, or mellow-out, neurotransmitters, followed by a carrier messenger, and then finish with the excitatory drivers of stress response. As discussed, anxiety can be due to a complex chemical equation of imbalance of these compounds: either deficiency of the inhibitory or an excess of the excitatory!
Serotonin
Probably the most famous neurotransmitter of the group, serotonin is an in
hibitory compound that aids in relaxation, anxiety, depression, memory, socialization, sexual function, sleep, blood pressure stability, pain, appetite, and digestive regularity. Serotonin receptors, although concentrated in the forebrain, are found throughout the body, including the intestines, heart, blood vessels, uterus, and ovaries. Beyond its direct effects, serotonin has the ability to modulate the release of other neurotransmitters as well as hormones that regulate sexual function and stress response. There are many types of serotonin receptors but the most well-known are 5-HT1, which is the primary inhibitory receptor, and 5-HT2, which is primarily excitatory and the focused hit for many psychedelic drugs, driving hallucinations in excessive stimulation. Drug therapies have been developed to work on both receptors, either to suppress or enhance activity for reduction in anxiety and mood stability.
Regardless of medication use and supplementation support, consuming a diet rich in tryptophan food sources can aid in production and utilization of serotonin. There are no known food sources of 5-HTP (a precursor to serotonin), but tryptophan is found in poultry, beef, fish, dairy, seeds, dates, chocolate, and spirulina, to name a few. If not on an anti-anxiety medication, supplementing with 5-HTP at 50 to 200 milligrams in a synergy formula, including B6 as a cofactor, could be of benefit. However, long-term use of 5-HTP can, over time, dampen mood by depleting your dopamine and other excitatory compounds. To prevent depression, I suggest minimizing supplementation with 5-HTP to no more than three to six months of daily use unless monitored and advised by a practitioner.