Has Your Doctor Missed Something?

Causes of Debilitating
Anxiety
Ronald Grisanti D.C., D.A.B.C.O., D.A.C.B.N., M.S.

Real Life Example of Anxiety

It's normal to feel anxious or worried at times. Everyone experiences a certain

amount of nervousness and apprehension when faced with a stressful
situation. However, when anxiety becomes excessive or prolonged and
begins to interfere with your ability to perform your daily activities, that's when
you can say one has crossed the road from simple worry to a full force illness.

Imagine you are walking down a dimly lit road and out between two parked
cars a man with a gun confronts you and demands that you give him all your
money or he will kill you. As you can imagine, your heart quickly begins to
thump, your legs feel like rubber, you want to run but you are paralyzed with
fear. By shear luck, out of the corner of your right eye, you see a police car
and without a moment hesitation, you scream and gain the attention of your
hero. You are saved!

As the criminal is whisked away in handcuffs, you begin to gain a sense of

calm. Still nervous but all in all an inner contentment that you just for the first
time in your life you looked death right in the eye.

Now what would you say if I told you that a full blown anxiety or a major panic
attack have all the same characteristics as the above scenario.

Yes, you will get that same pounding heart, you will be paralyzed with an
intense terrifying fear, you will get nauseous, get lightheaded and a bunch
more symptoms soon to be explained.

Unfortunately, unlike the victim who was lucky to be saved by the police
officer, anxiety suffers continue to experience these terrible symptoms day in
and day out. The anxiety victim soon becomes a prisoner within their own
body not knowing if they will ever see the sunshine or the birds sing again.

Anxiety Overview

You see, there are more than 19 million Americans suffering from all anxiety
disorders combined. It's normal to feel anxious or worried at times. Everyone
experiences a certain amount of nervousness and apprehension when faced
with a stressful situation. However, when anxiety becomes excessive or
prolonged and begins to interfere with your ability to perform your daily
activities, that's when you can say one has crossed the road from simple
worry to a full force illness.

Most people are convinced they are minutes from dying and experience
something commonly called "impending doom". They are frequent visitors of
the local emergency room. Test after test continues to show that nothing life
threatening is wrong.

Unfortunately, the anxiety sufferer is still not satisfied. Something has

obviously been overlooked. So more tests are run only to once again find
nothing wrong. Soon their family and friends begin to label you a
hypochondriac. It must be all in your mind they say.

Signs and Symptoms

The signs and symptoms of anxiety can vary in combination or severity. They
may include:

 Restlessness
 Feeling of being keyed up or on edge
 Feeling a lump in your throat
 Difficulty concentrating
 Fatigue
 Irritability
 Impatient
 Being easily distracted
 Muscle tension
 Trouble falling or staying asleep (insomnia)
 Excessive sweating
 Shortness of breath
 Stomachache
 Diarrhea
 Headache
If you have anxiety you may feel on edge about many or all aspects of
your life. For example, you may feel intense worry about your safety or
that of your loved ones, or you may feel that something bad is about to
happen, even when there's no immediate danger. When you feel
anxious, your body releases hormones that prepare you to react to a
threat. This is called the fight-or-flight response. When anxiety gets out
of control, this response can occur almost continuously, even at times
when you seem calm.

Clinical Lab Assessments

Some of the following laboratory testing can provide information
necessary for diagnosis and treatment. In addition, the tests listed may
also give insight to functional metabolism and functional nutrient status
in the body. 
 Adrenal Stress/Cortisol Testing/Neurotransmitter Testing: Adrenal
insufficiency can lead to a host of problems, including a weakened
immune response, anxiety and panic attacks. Imbalance in
the Hypothalamic-Pituitary-Adrenal axis (HPA) is involved in anxiety
related disorders. In this complex, adrenal functional abnormalities are
relatively simple to identify and address. Plasma or salivary cortisol
measurements can be used as a marker in the evaluation of stress
syndromes that may relate to anxiety disorders. Some study has
 suggested that altered cortisol response to stress in panic disorders
may complicate successful lifestyle intervention.
  
 Thyroid Profile
Elevation of thyroid antibodies has commonly been found in individuals
with anxiety disorder. Correlations have been observed between
thyroid laboratory values and anxiety. Assessment of thyroid hormone
production, peripheral hormone conversion, cellular sensitivity
response, thyroid hormone antibody activity can provide critical
information for intervention with a goal of optimal function.

 Allergy and Food Sensitivity Response Assessment

Allergic responses to foods, inhalants and environmental chemicals,
and other substances can cause a variety of responses that induce or
aggravate anxiety. Screening can enable an individual to eliminate or
minimize exposure to unfriendly allergens.

 Organic Acids
Organic acids analysis is a useful method for measurement of
biochemical intermediates in urine. These intermediates can offer
information about key enzyme functions and nutrient competence
(amino acids, nutrient cofactors, minerals, and fatty acids). Elevation
of vanilmandelate reflects elevations in epinephrine and
homovanillate indicates norepinephrine elevation. High levels of these
neurotransmitters are associated with physiologic inability to manage
stress.
 Melatonin Level
 Rule out Progesterone deficiency or Estrogen Dominance
 Rule out Lyme Disease
 Rule out Mycotoxins (Mold)
 Rule out Pyroluria
Pyroluria is a known biochemical marker for life long anxiety
symptoms. According to one alcoholism treatment center, one-third to
one-half of alcoholics treated have this marker. High levels of pyrrolles
systematically bind to B6 and zinc, preventing the use of these
nutrients in the body and brain. The result is a myriad of symptoms,
including severe inner tension, ongoing anxiety, poor stress control,
fearfulness, and sometimes episodic anger.
 Obtain Magnesium Levels via RBC erthrocyte assessement
 Rule out Mercury Toxicity
 Amino Acids
Deficiencies or imbalances in amino acids can indicate fundamental
reasons for numerous disorders. Amino acid malabsorption syndrome
or imbalanced amino patterns reflect abnormal organ and glandular
processes that have critical bearing on optimal function. Phenylalanine
and tyrosine are precursors to the catecholamines and affect the
capability to manage stress in anxiety disorders.

Treatment Options
Conventional Medical Approach
Prescription drug treatment includes anti-anxiety agents such as
lorazepam (Ativan), alprazolam (Xanax), and buspirone (Buspar).
Antidepressants, such as fluoxetine (Prozac), paroxetine (Paxil), and
venlafaxine (Effexor), are often prescribed to treat generalized anxiety
and panic attacks.

Nutritional Medicine
Magnesium
Magnesium may provide benefit for people with anxiety. Symptoms of
magnesium deficiency include anxiety, nervousness, insomnia, muscle
fatigue, and tachycardia. Clinical studies have supported the theory
that anxiety is one of the symptoms that can occur in individuals with
magnesium depletion.

Vitamin B6
In a study of individuals suffering from frequent anxiety attacks,
patients were given vitamin B6 (125mg, 3 times daily) and tryptophan
(2 grams daily). This regime enabled in 70 percent of patients (9 of 13)
to become free of anxiety attacks within three weeks. Vitamin B6 is
required for the conversion of tryptophan to serotonin. Therefore, a
deficiency of vitamin B6 may result in symptoms of anxiety and
depression due to inhibition of serotonin synthesis. In a study of
individuals suffering from frequent anxiety attacks, patients were given
vitamin B6 (125mg, 3 times daily) and tryptophan (2 grams daily). This
regime enabled in 70 percent of patients (9 of 13) to become free of
anxiety attacks within three weeks.

Inositol
Clinical studies have found that inositol may be a valuable natural aid
for patients suffering with Panic Attacks and may provide benefit for
anxiety suffers. Biochemically, inositol is precursor for the
phosphatidyl-inositol system and as such should be considered for its
impact on elevated cortisol levels.

A double-blind, controlled study comparing the effect of inositol against

fluvoxamine in panic disorder. Twenty patients completed 1 month of
inositol up to 18 g/day and 1 month of fluvoxamine (Luvox) up to 150
mg/day. Improvements on Hamilton Rating Scale for Anxiety scores
were similar for both treatments. In the first month, inositol reduced the
number of panic attacks per week by 4.0 compared with a reduction of
2.4 (2) with fluvoxamine.

5-Hydroxytryptophan (5-HTP)
Studies that induce low levels of tryptophan result in low serotonin
levels, which can cause anxiety. Tryptophan and 5-hydroxytryptophan
(5-HTP) are the precursors for serotonin. Tryptophan is an essential
amino acid that the body cannot manufacturer. Tryptophan is
converted into 5-HTP, which in turn is converted into serotonin. There
is ample evidence that tryptophan depletion causes reduced synthesis
of serotonin, which can result in anxiety and other mood disorders.
 Patients taking anti-anxiety drugs or other antidepressants should not
take tryptophan or 5-HTP without the supervision of a health care
professional because it can increase the effects of other
antidepressants.

Tyrosine
Tyrosine is the precursor to the neurotransmitters dopamine,
norepinephrine, and epinephrine, which all influence and regulate
mental and emotional states. In a clinical study reduced brain tyrosine
levels caused a reduction in catecholamine synthesis. This caused
decreased calmness, increased tension and anger. The authors of this
study state that brain catecholaminergic dysregulation is involved in
pathological anxiety states.

Phosphorylated Serine: should be considered with elevated cortisol

levels

Herbal Medicine
Several plants, known as nervines (nerve tonics), are used in
traditional herbal medicine for people with anxiety, with few reports of
toxicity. Most nervines have not been rigorously investigated by
scientific means to confirm their efficacy. However, one study found
that a combination of the nervines valerian and passion flower reduced
symptoms in people suffering from anxiety. In a double-blind study, 45
drops per day of an extract of passion flower taken for four weeks was
as effective as 30 mg per day of oxazepam (Serax), a medication used
for anxiety.

Passionflower
Passionflower has been reported to have sedative, hypnotic,
antispasmodic properties. In humans, passionflower has been reported
effective when used in combination with other sedative and anti-anxiety
herbs such as valerian.

Valerian
Valerian has long been used as an agent to soothe the nervous system
in response to stress. It has been reported that valerian helps improve
sleep quality.

         Theanine

 Diet & Lifestyle

 All sources of caffeine should be avoided, including coffee, tea,
chocolate, caffeinated sodas, and caffeine-containing medications.
 Avoid sugar and refined carbohydrates.

Stress Reduction
Stress reduction can take form in a variety of ways. Some of the more
 structured forms of anxiety relief include; counseling, tai chi, yoga,
meditation, deep breathing. These tips may help reduce your anxiety:
 Take action. Determine what's making you anxious and address it. For
example, if finances are your concern, draw up a budget.
 Let it go. Don't dwell on past concerns. Change what you can and let
the rest take its course.
 Break the cycle. When you feel anxious, take a brisk walk or delve into
a hobby to refocus.
 Take care of yourself. Get enough rest, eat a balanced diet, exercise,
and take time to relax.
 Talk to someone. Share your problems with a friend or professional
counselor who can help you gain perspective. Clinical Notes
A variety of conditions could contribute to feelings of anxiousness.
Consider evaluating the individual for heavy metal toxicity, dysbiosis,
as well as DHEA and cortisol as initial steps. The key nutrient to
consider is magnesium.

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