Are you dealing with anxiety and want to take the reins on your life? Know there is more to the story in terms of treatment but unsure of where to start? Tune in to hear Ali and Becki tackle the often taboo subject of anxiety from defining the broad range of symptoms to Ali’s 6 Foundational Rs for managing anxiety. From decreasing inflammation to restoring the gut microbiome, Ali and Becki go deep into how diet can help you to find long term solutions and freedom from anxiety, worry and rumination!

In this Episode, Ali and Becki discuss the foundation of an Anti-Anxiety Diet and how you can use food-as-medicine as well as nutraceutical supplement recommendations for managing stress, worry and anxiety. From defining anxiety to the symptoms that are seemingly unrelated, this important episode gets to the root causes of the “elephant in the room” that is anxiety. From inflammation to gut dysbiosis to micronutrient status and adrenal gland function, there are a multitude of underlying factors at play when patients experience anxiety. Ali and Becki give recommendations for simple dietary changes as well as more advanced functional medicine testing to get you feeling back in the driver’s seat of your body!

Also in this episode:


Welcome to the Naturally Nourished podcast, that delivers cutting edge food as medicine solutions for optimum health. Ali Miller is a nutrition expert sought out by the media and America’s top medical institutes for her revolutionary functional medicine interventions. From disease treatment to prevention, every episode will empower you with ways to put yourself back in control of your health. Please note, the topics discussed are for educational purposes only. Now welcome integrative dietitians Ali Miller and her co-host Becki Yoo.


A: Welcome to the Naturally Nourished podcast, thank you for joining us on episode 54. Today we’re talking all about anxiety, Ali here along with Becki.


B: Hey everyone.


A: And I’m super excited to do today’s episode as I feel it’s a topic that impacts so many of us, yet we all could be hesitant to admit or state the term “anxiety” maybe due the shame or truly not taking the time to reflect and label.


B: Yes and I see this one so often clinically but usually I don’t get an overt answer like a patient doesn’t say “I’m dealing with anxiety” unless maybe that’s the condition bringing them in. Usually it’s going into their medication list and kind of reading between the lines and asking a lot of questions about stress, how stress manifests in the body, sleep, asking about ruminating thoughts so a lot of times I see that patients don’t think it’s’ a relevant conversation to be having with us as dietitians or that there’s anything that we can do in terms of diet.


A: Absolutely and I think that beyond that just day-to-day functionality can be improved if we can reduce our anxiety so even if it’s not something that’s detrimental or playing a role that’s overtly being assessed by the individual or experienced as a problem, there’s always a way to improve our mindfulness and feel more relaxed which generally means better outcome across the board, so with relaxation comes more joy so that’s always a beautiful things.


B: Sure so I’m really excited to delve into today’s episode and talk to you Ali about some of the underlying mechanisms, discuss some of the food as medicine solutions, and I know you have a lot to share with our audience so let’s go ahead and get started with how you define anxiety.


A: Sure so I mean technically the term is a feeling of worry, nervousness, or unease and typically anxiety based episodes are on an imminent event or something with an uncertain outcome and it can be seen as apprehension. Now, if this worry or nervousness becomes excessive where it’s occupying our mental space or most days of the week, and it’s continuing for more than 6 months, then this may be diagnosed as generalized anxiety disorder. So some of the symptoms of generalized anxiety disorder can include restlessness or feeling keyed-up or on edge, being easily fatigued, having difficulty concentrating or loss of memory or mind going blank that’s like “oh I’m supposed to be in here to do what” type thing. Irritability in general can also be associated with generalized anxiety disorder, muscle tension and or muscle spasms and twitches, even aches from just holding tension in the muscles and then sleep disturbance so whether it’s difficulty falling asleep or staying asleep or restlessness or overall unsatisfying sleep and like Becki said, these are questions we ask people in their intake and I think a lot of people would fall under this criteria.


B: Definitely once you start asking the questions.


A: Yes.


B: So beyond just these common symptoms, I’d say that a majority of our clients experience at least a couple of these, if not all at some point in time. There’s some unknowns with anxiety. Many people who are suffering may avoid social situations for example, or they might not take advantage of certain opportunities due to worry, such as social situations, travel, not taking advantage of a promotion or a new job or they may spend excessive time on kind of your typical tasks like grocery shopping could feel really overwhelming or driving their car somewhere or getting on the freeway.


A: Yes and especially when things are pending, I hear that a lot from clients and we talked about this with the- oh goodness what episode number was that the finding out bliss, my recalibration, if you will, where we talked about, you know, pending tasks can be the most debilitating with anxiety so these are the things that mood over us, so even something as simple as grocery shopping, people that deal with severe anxiety it like hangs over their head like a black cloud. Like “ugh I have to go grocery shopping” and the buildup can be actually more detrimental than the actual activity itself and so I really try personally to stay acutely aware of pending and work with lists and kind of acknowledgement and resale and scheduling things ort so we can be realistic with ourselves and our expectations, and we can release from the unknown. So I think that’s definitely things to consider.


B: Yeah that was episode 43 was Living Your Bliss and we talked about some techniques to kind of compartmentalize and deal with some of those pending tasks in that episode.


A: Yes.


B: So even you, Ali, experience anxiety? If you’re not kind of checking yourself?


A: Uh yep absolutely and, you know, I think beyond, it’s funny I recently- my recent story of anxiety is and it ebbs and flows, I noticed personally some hormonal trends with anxiety, and especially if I have missed support with my progesterone there can be more perpendencies towards anxiety and it’s definitely a hormonal correlation of progesterone deficiency of estrogen dominance having more anxiety-like tendencies so sometimes the day right prior to applying my progesterone I’ll be a little more uptight and it’s like “oh my body needs progesterone” that’s one of those a-ha connections, but as of recent I was taking Stella to a music class and, I mean, I feel grateful in the sense that I’ve been able to compartmentalize my work schedule and flow to take her to a music class so on Wednesdays I work from 12:30-7pm so in the morning hours I’m able to take her to music and you know, the last group of music she was with all these 3 year old boys and they were like 3 year old boys, no inhibitions and just going crazy and not listening to the agenda and so in that classroom Stella was just a little gem and she also couldn’t walk yet.


Well now she can walk and there’s only 1 boy in this class and he’s, like, the most mellow child that just like sits by his Mama and does everything as requested, and so Stella’s like picking up the drums when it’s not drum section, when it’s mellow-out time in the class and the piano teacher’s playing the piano, Stella walks over to the piano is touching the key sand it’s just like this constant like I feel like “oh my gosh, oh my gosh” and everyone’s looking and me and I’m the bad mom and, you know, I’m not really a stay at home mom so I don’t really know what I’m doing and all that stuff it kind of unleashes and so this last class, I make myself take a GABA Chew, and I swear it was a whole different ballpark so, I mean, there’s things that we can do and we’ll talk about the beauty of GABA chewing I know it’s one of your favorites too, Becki, but we can experience anxiety even from something joyful like attending my child’s music class, yet based on my biochemistry in that time of the month based on my stress load, my sleep the night before, I’m going to have different reactivity to it and sometimes I’ll respond with anxiousness and sometimes I’ll respond relaxed and so hopefully today, you guys, we can give you all tools to be in the more mellow mode where things don’t get us as upset or agitated or irritable and we have clairvoyance and a clam mental state. That’s the goal.


B: Awesome.


A: Yeah- so yeah, go ahead.


B: So I was just going to say, let’s talk about more of these functional medicine approaches. I know at our clinic we focus on your 6 foundational R’s for managing anxiety, so I’d love for you to define these 6 R’s for listeners and then let’s highlight 1 or 2 that we would say are the most important.


A: Ok so the Antianxiety Functional 6 R’s that we have as far as a foundational protocol are to: remove inflammatory foods, reset the gut microbiome, repair the GI lining, restore micronutrient status, rebound the adrenals, and to rebalance our neurotransmitters. So it’s a lot of R’s and, you know, the first 3 are focusing more on the gut because that does play such a role with chronic inflammation of course and then we’re hitting the building blocks, if you will, and some of the glands of target.


B: Yeah so it’s a lot of factors and we could kind of start at any one given place, but usually starting with the gut and getting to the building blocks and then getting into the adrenals and neurotransmitter piece, but if could start kind of at any place in that 6 R puzzle. So let’s talk about just the foundational aspects of an anti-anxiety diet and where to start.


A: Yes so first things first, we want to start with clean, single ingredient whole foods so when we’re looking at starting with a foundation we want to make sure that we’re not eating foods that have high amounts of colorants or irritants, so chemical additives have been shown in research to drive things like ADHD, hyperactivity disorders, and these also in adults, can create anxiousness so starting with clean, single, ingredient whole foods in your foundation and then we also want to look at a low glycemic index diet because we do see that blood sugar irregularities also drive symptoms so too high or too low of blood sugar can drive very similar symptoms to anxiousness so that’s one of our foundational things. So in order to keep glycemic index in check, we want to make sure that we’re reducing our carbohydrate intake, pairing all carbs with proteins and healthy fats so adding in those healthy fats for sure, and then getting enough protein because protein is a contributor towards amino acids. So our amino acids are actually our building blocks to make neurotransmitters so that is going to be able to create the foundation of the  brain chemistry that’s needed for sound mood and stability. And then those fats also beyond helping with glycemic index also play a big role with being very grounding. Fats can help to balance our hormones, they can also aid with satiety or satiation, and can reduce cravings and I find that when blood sugars are off and cravings are up, that that drives anxiety-like behaviors too.


B: Ok so a lot of this sounds kind of like the foundational aspects of optimal eating, or low glycemic diet that we talk about in a lot of our episodes, if not all of them. But I want to highlight for listeners some of the symptoms of dysglycemia or imbalanced blood sugar.


A: Yeah so there’s totally overlap and parallels that we see. So shakiness and nervousness are two of the main things that we can see. So nervousness is pretty much how I define anxiety so shakiness, nervousness, hunger, irritability and shortness and some people call that
“hanger” so when hunger and anger blend into a hybrid we get “hanger.” And headaches, so all of these things can be seen with dips and low blood sugar and then the high blood sugars typically yield more of fatigue and brain fog or difficulty with concentrating, so both ends of the spectrum we can see symptoms of anxiety, often more of the lows and the deal is, you may think that “oh a lot of people that deal with hypoglycemia or reactive hypoglycemia always feel like they need just a diabetic ‘I need my orange juice I need my quick acting carbs’ otherwise I get into this irritability, this hanger mode” well also, you could reduce your body’s need and utilization of glucose and/or reduce the glycemic index so that you have more of a speed bump shift in your blood sugar metabolism versus these mountain peaks and valleys because remember as high as your glucose peaks, you’re going to get an even higher response of insulin and it’s that excessive insulin that these reactive hypoglycemics that dips them too low and creates that an anxiety-like tendency. So actually preventing the blood sugar spike in the first place is going to prevent also the blood sugar drop which causes a lot of these symptoms.


B: Got it, so there’s a lot of overlap but it might even be difficult to distinguish, “am I truly experiencing an emotional anxiety or is it more just what I’m eating or it could be a combination of both?” Right?


A: Yeah absolutely so that’s the best way to start to create that balanced glycemic index for sure.


B: Ok and then beyond macros and whole foods, how do we start – let’s talk about addressing the most inflammatory foods in the diet.


A: Yes so you know, for those of you who have listened to a couple of the episodes you know that I’m a big proponent of the MRT test which stands for Mediator Release Test. This is a blood panel that looks at 150 foods and chemicals and looks at your body’s inflammatory response specifically to them and so this is kind of how I use like a GPS for the patients in my clinic. And if dealing with severe anxiety disorder or bipolar or mania, we would definitely want to consider starting with the MRT test. Now for everyone else, what might be the most cost effective way is to just jumpstart in my foundational 5 pro inflammatory foods and so we’re looking at gluten, corn, soy, dairy, and industrialized oils. And so gluten we’d be watching removal of because the hybridized form of gluten has significantly higher amounts of glutenin and gliadin is the inflammatory protein particle in gluten grains.


Gliadin is high in wheat specifically, especially the sort of dwarf hybridized form of wheat and this has been shown to be in genetic crop, meaning that it actually causes weight gain and can cause over-sweating, but beyond that, it can drive dysfunction in the gut and the thyroid. So the gliadin structure actually mimics very much the thyroid hormone, and this can create confusion within the body and can create autoimmune or inflammatory attack on the thyroid glands to that’s definitely a no-no and hypothyroidism and hyperthyroidism can also mimic anxiety significantly. There’s a tight correlation there so definitely want to make sure that they thyroid is in check when we’re experiencing symptoms of anxiety. Also on the gut level, gluten can cause more enteropathy or basically damage to the gut or leaky gut, so by removing this this can make our gut rebound better or be less inflammatory which means less sensitivity across the board. So gluten we’d like to keep out for sure.


Then next one that we want to look at is corn. So corn we like to remove more because of the toxic byproducts associated with corn. So when we’re talking about corn, it’s the glycophosphate from ground-up so there’s ground-up bready corn which is genetically modified to stand up to more application to the glycophsopate which is the chemical compound in round-up which can be a neurological toxin so that definitely plays a role with mood stability and neuromuscular function and then the other form of genetically modified corn is an endotoxin and this is the BT corn. This is the corn that has the compound in it that actually is to explode the guts of the insects that eat it, the worms on corn, and so the BT corn has endotoxin which has been shown to, like I said, perforate the bowel or the guts of insects, that’s how it kills the insects and works as an insecticide but that also could play a role on driving our leaky gut as a toxin that is consumed and breaks down on that gut lining. So corn because of the residual toxins, is something that I definitely recommend keeping out as well.


B: That’s pretty scary stuff when we get into guts exploding.


A: Yeah, right? I know.


B: And then on that same vein, what about the influence of soy, so talking about the thyroid and some of the genetically modified aspects of soy as well?


A: Yeah so soy is also a high GMO crop so it has higher amounts of that glycophosaphate residue, so the neurotoxins- it is also high in a lot of what are called anti nutrients, the what that that legume plant is, has a lot of protective compounds that block mineral absorption and also can bind and it can in that sense, drive mineral deficiencies in the body. And then can also cause some GI distress for that reason. It has some estrogenic influences, so as I mentioned before, having estrogen dominance or progesterone deficiency can also drive anxiety so definitely want to keep estrogenic foods out and then soy is high in omega-6 , so it’s more of a proinflammatory versus omega-3 anti-inflammatory.


B: And then we mentioned dairy, so let’s talk about dairy and the influence of casein, the dairy protein.


A: Yes so dairy also has the hormonal influence that it can be estrogenic so that’s a trend overlap with the soy, the casein especially there is an anti-casein IgG or a compound that some individual make that actually battles casein so this is something that you can get tested as a blood test if you feel that you have mood response to dairy, but I guess the first thing to do is to remove it from the diet and see if you feel better. But there has been actually research study that was done on correlation of the anti-casein IgG, and strong association with bipolar, schizophrenic disorder, and that’s something that like I said, is a very easy solution of removal especially if we’re dealing with mood stability.


B: Ok and then finally, let’s talk about industrialized oils and why these would be problematic.


A: Yeah so industrialized oils, this is like especially canola oil or vegetable oils, they’re going to be high in your omega-6s so they’re pro inflammatory. They also tend to have a really high free radical overload the way that they’re cleaned to make clear oils form a very dirty product there’s a lot of centrifuging, stirring, chemical hexilants are used in the cleansing process so there’s a lot of byproducts and the industrialized oils tend to have a pretty low smoke point so this creates more free radicals when they’re used improperly which more of our processed foods use too high temperature that are going beyond that smoke point, creating oxidative damage so I like to keep out the industrialized oils as well so it’s’ the gluten, the corn, soy, dairy, and industrialized oils.


B: Got it. And I think listeners would really expect at least those first 3 gluten, corn and soy I’m sure they’ve heard us talk about a lot, but now let’s circle back a little bit to dairy because I thought here were some forms of dairy that you prefer over others, and that there are some benefits to casein as well as a relaxant or relaxing agent in the body.


A: Yeah, absolutely. So I spoke to that when we talked about the benefits of breastfeeding so casein absolutely it actually hits the opioid receptors, and there is varied forms of casein be it the type of cow so Jersey cow versus a standard cow that’s used more in the conventional milking, and casein does have opioid effects that can be relaxing, however, for those that have that IgG antibody to casein, it’s safer cost-benefit ratio to keep it out because the people that have that antibody get manic reactivity to the casein because their immune system goes into this extreme inflammatory attack mode. So when we’re talking about different forms of dairy, casein is the highest in cheeses because the formation of cheese is the separation of the casein and whey and casein and whey are the two dominant proteins in cow’s milk product and cow’s milk so whey makes up about 20% of the protein in milk as a liquid whereas casein is in the 80% so casein is high in dairy milk and cheeses and then it’s – there’s’ some dairy forms that are free of casein like whey and ghee.


B: Ok so I was going to ask, we’re always advocating for our Naturally Nourished GrassFed Whey so where does that fall into this spectrum?


A: So the whey is casein-free and it’s especially less concerning because our whey is non-denatured so it’s actually therapeutic to the gut. It  has some heat sensitive detoxifying compounds like glutathione which can help with detoxifying heavy metals which can drive things like anxiety and neurological dysfunction and then it has the active immunoglobulins which can help with relining the gut and support immunoglobulin regulation. So if you want to be super conservative, you could keep all forms of dairy including the grassfed whey out for the first 2-3 weeks and then bring in the whey as an independent variable before you’d bring in any of the other of the 5 inflammatory sections of foods in your elimination diet, keep the rest of those out for a full 6 weeks so it’s’ the casein protein that crosses the gut blood barrier and the brain blood barrier and grassfed whey especially ours which is non-denatured is much more therapeutic and is free of the casein compound.


B: Ok so that makes sense looking especially, especially looking at amino acid deficiency and how that can drive neurotransmitter dysfunction and gets more of a cost-benefit relationship here.


A: For sure Grassfed Whey is the greatest source of natural compounds like I said, not only glutathione but L-glutamine and tryptophan so you’re getting all of these  amino acids that help to build your feel good neurotransmitter in a biologically active approach.


B: That- ok so no let’s talk about dysbiosis and imbalance gut bacteria briefly. So what’s the connection and what’s a good starting point for listeners?


A: So the microbiome and the GI tract in general is the manufacturing center control for our neurotransmitters so we manufacture a majority of our serotonin and GABA in our intestinal tract and the bacteria state plays a big role in either disruption or creating optimal function. And so when we’re talking about resetting the microbiome as far as a foundational focus of this or, you know, creating good gut microbiome expression, one thing to do is to plow the fields of the GI tract and so something that I’d recommend to all clients if dealing with anxiety and especially any other signs of dysbiosis so maybe a moderate amount of bloating, more irregularity in the bowels, from loose stools to constipation or having an AGI cramping or dermatological flare like hives, rashes and such. The best place to start would be with our Beat the Bloat Ebook. So just doing a dysbiosis and/or candida cleanse can plow the fields to basically reset the microbiome and then you can prophylactically add back in the good bacteria to ensure that you’re setting up camp with the good guys.


B: And for those of you who are new to our website, to, just so you know, the Beat the Bloat Ebook is located under the Books and Program tab, and this is a 30+ page Ebook that contains information about what dysbiosis is, what candida is, what signs and symptoms might be experienced, how gut bacteria can cause full body imbalance and then it includes 2 phases of a cleanse so the first being that plow the fields as Ali mentioned and then the second being that restoration and setting good bacteria.


A: Yeah so it’s all broken down into a 10 week program and has weekly meal plans and recipe suggestions and a grocery list also I really find it to be a really cost effective way for clients to get in  there and reset and then re-innoculate and then if they’re still having resistance or difficulty tolerating, we might go deeper into the rabbit hole by doing a stool test to see if there’s anything going on and if there is any pathogens or parasites or things that we have to get really aggressive with.


B: Got it and then that second phase is really where we’d see that rebuild of good bacteria that are going to promote serotonin production.


A: Yeah it’s really important to note that actually some clients do get a little bit more anxiety or mood disturbances during the cleanse, especially as they get in weeks like 5 or 6 when they’re doing a lot of the antibacterial and antifungal compounds, and that’s because they came from a state of sterility where they’re really low on their neurotransmitter production basically, and so sometimes on an individualized level we might bring in  a probiotic a little bit earlier, we do all work in the protocol to bring in a probiotic as early as week 4. So for those of us who are sensitive, we’d want to bring in probiotic foods starting at week 4 and then like a Baseline Probiotic maybe even starting and week 4 and then at week 7, after the 6 week cleanse, hit with the Bacteria Rebuild Bundle, which is going to have your kind of full spectrum of support of rebuilding all of the compounds to help with the neurotransmitter balance.


B: Got it. And then also, Ali, if folks experience a flair or worsening of symptoms when they’re using a probiotic, that can also be a sign of dysbiosis, right?


A: Yeah so if you’re not interested in going down into the well I would definitely first check out the Ebook, read it, see if it feels like a hit, take the candida quiz in there and if you feel overwhelmed or not sure if you need to go through a cleanse, you may consider doing a probiotic challenge and so this can be done where you take about 15 billion cultures of a 50/50 blend of a lacto and bifido strain probiotic and you start with 15 billion and you could do this in 3 day increments, or 1 day increments where you monitor and watch things like your waist circumference. You can look at your waist circumference from rise to rest and then the next morning again, and see if there’s a variance of greater than 2 inches. So if you see a variance of greater than 2 inches in your gut without the probiotic and then when you add in the probiotic it improves, that’s one sign of dysbiosis is the good bacteria’s helping to set up good colonization, that’s improving your microbiome. Now if you see a decline or urgency of stool, or a dynamic change of bringing in the probiotic like more bloating or a battle going on in the belly, then this is a marker of dysbiosis, right? So when we’re looking at that were actually going to have to starve off the bacteria or plow the field before we can bring in and tolerate the probiotics so these are all things to consider so seeing if you respond well to probiotic foods and/or probiotic supplementation could be a first line of defense before you even do a cleanse and that would be fine. But if you do have a flare or regression or a bad response to a probiotic, then that’s a strong indication of a need to do a bacterial cleanse.


B: Ok so I think we’ve covered the gut portion to an extent. We talked about foods to eliminate and then we talked about the role of dysbiosis or overgrowth of bad bacteria. I also think that we’ve covered a lot on adrenal fatigue and that adrenal element of anxiety, that was in episode 13, and then the HPA axis I’m sure you guys have heard us talking about over and over and we have a full episode, episode 11, about the HPA axis.


A: Yeah so that would cover our rebound the adrenals as our “R.”


B: Yes. And then let’s focus our last element here on micronutrients and then genetic SNPs.


A: Yeah so I think this is some new information for you guys. So let’s talk maybe about the SNPs first so one of the main ones that’s talked about is the MTHFR. So SNPS are single nucleotide polymorphisms, ok? And they’re basically genetic mutations. And these are genetic, so they come from Mom and Dad, so we have our 23 paired chromosomes and Mom and Dad each contribute one to make a pair, right? And so this is the double helix of our DNA , this is our genetics and so the genetic SNPs are things that do not change, they are stagnant , they are not dynamic, they are what you’re born with and then your body biochemically is going to have varied expression based on these potential genetic mutations. There is a lot of testing now whether it’s 23 and Me, or there’s so many different labs now, there’s Genova Diagnostics that can look at these SNPs and then functional medicine practitioners can use these to help the body to find balance and to support the system.


So when we’re talking about MTHFR, this one stands for methyltetrahydrofolate reductase and so, yeah, a lot of syllables in there, but basically you may have heard the word “folate “ in there – it plays a big role in the utilization of folic acid, And MTHFR plays a big role in building or excreting so it’s playing a role with DNA synthesis, building DNA; it plays a big role with trans-sulfuration and then it plays a role with detoxification and homocysteine loads in the body so it can excrete the excess homocysteine which is a marker of vascular inflammation. It can also play a role with detoxification. So when we look at people that have the MTHFR mutation, this can play a significant role on our neurotransmitters because it intermittently related to B vitamins be that folic acid is B9. And so when we’re talking about- we call it folic acid – and so when we’re talking about our B vitamins, B vitamins can be in a bioactive form, which is a methylated form, so for this sense, a form of folic acid in a supplement could be called folic acids, which is a synthetic or it can be taken in the form of methyl-tetrahydrofolate. Or it might just have methylfolate, or methyl 5-folate in there.


Same thing with B12. B12 can be taken in varied forms. The cheapest, the one that I do not recommend, is cyanocobalamin which for someone that has a MTHFR mutation could build up into a toxic compound, or derivative of cyanide, but the methyl form of B12 is methyl cobalamin. So in the laymen, easiest way to explain this, is a SNP is a genetic mutation. It can play a role on our biochemical expression and the biggest known one our MTFHR can play a role in building or excreting. So people that have genetic mutations, there’s a C copy and an A copy. The C677T plays a role in about 60-70% of your body’s methylation function, whereas the A1298 is about 30%, and then even within these you can have hetero or homozygous expression meaning if someone was heterozygous C copy, that would mean that they’re functioning at about 70% active functionality because the C copy plays 60-70% of the expression, and hetero means half of their C copy is from only Mom or Dad is genetically mutated. So if they were homozygous C copy, they would only be functioning at about 30% methylation because both of those C copies are genetically mutated and that means they don’t have that use of that 60-70%. So, is that a lot of beep boop bop boop for listeners, Becki?


B: That’s a lot, so it’s kind of a spectrum is what you’re saying with the A copy, the C copy, and we could be on a spectrum where we have a slight impairment in methylation all the way to where we’re almost all the way impaired, if you will?


A: Yep. Absolutely.


B: And then most informant thing to be looking for in our B vitamins, whether we’ve had the testing or not, honestly, if you’re suspicious that you might have this genetic mutation, looking for those methylated forms of B12 and folate.


A: Right so our Multidefense, which is our Baseline Antioxidant abundance multivitamin uses all methyl forms so we would never recommend something that’s non-methylated for that reason. And that’s going to generally help to turn that wheel of the methylation process, which will help to regulate your body’s building and excretion pathways.


B: So if you take a multivitamin at home, homework is to go on there and look and see on your label if you’re taking a methylated B12 and methylated folate.


A: And even the ones you get at Whole Foods are often the synthetic form, so that is really the benefit beyond of using our Multidefense is knowing that it is going to be giving you those methyl donors.


B: Ok so that’s MTHFR and I know that there’s a lot of correlation with depression, anxiety, bipolar with the MTHFR mutation. Let’s talk also about the role of over-methylation.


A: Yeah so that’s something that I think is really important too. When MTHFR kind of got into the general public speak and this was probably about 3-5 years ago, everyone started over-methylating and that means that basically someone would say ”Oh well I’m just going to take this 1-5 g methyl folate supplement because that means I’ll be able to methylate on an extreme level so I’ll be building and excreting amazingly.” And that‘s kind of the American mentality like if something’s good, more must be better so we have to watch out there because we can actually over-methylate. Now the amount of methyl donors in like our Multidefense is not by any means at level that is going to overdrive these wheels so that’s definitely a first, do no harm, approach on a baseline hit.


But to take high levels of methyl folate or methyl cobalamin, can actually drive more anxiety especially if people have another big genetic variant called COMT. So COMT is catecholamine methyl transferase and what this really looks for are catecholamine’s are our stress responding neurotransmitters so our catecholamine’s are our epinephrine, norepinephrine, dopamine, and so when we have COMT variants and we’re over methylating, we’re spilling all these methyl donors that are getting trapped as overexpression of adrenaline and so this means that we’re not able to excrete or break down the byproducts and we start to have this overexpression of anxiety. Adrenaline can be good in some settings, but it can  also be excess. Insert the Incredible Hulk, right? If we’re feeling this out-of-our-body tension, which often happens with over-methylation.


So I’ve actually had someone that was taking a high methyl folate supplement and this was a 5mg methylfolate and they said that they were in the grocery store and they were just pacing like a lion. They were like “I had no idea what I was doing in the grocery store, I knew I was there to grocery shop but I just could not even – my mind couldn’t even slow down to tell me to grab the yogurt” they were just pacing and so that’s a classic – I mean that’s an extreme example of someone that has likely over-methylated and may be COMT variant so they need some support and the big go-to for those individuals are SAMe, which are S-adenosyl-L-Methionine. This is a compound that is made in the liver that helps with production of serotonin and helps with production of more of our inhibitory, or balancing, compounds and helps to methylate and methylate the COMT variant versus that MTHFR so it helps to reduce that build-up of that catecholamine and then also, glutathione. Glutathione is a safe way to support the body’s’ process of building or excreting without creating that excessive production of the methyl folate or methyl cobalamin.


B: Got it. So I hope we didn’t go too deep into those SNPs.


A: Like “got it, I think.”


B: I think we got it. So beyond just talking about just B vitamins as cofactors for activating these neurotransmitters let’s’ get into some of the amino acids that help us to build our neurotransmitters in the first place.


A: Yes so when we’re talking about the amino acids, we’re talking about things like glutamine, tryptophan, tyrosine, and L-threonine and we do talk a lot about this in episode 35, which is Boosting Mood with Food. But I definitely want to give you guys a little sampling of what these compounds can do. So glutamine is seen more in our excitatory world of our neurotransmitters. Glutamine can- all of these, first off- all of these amino acid compounds come from protein and so this is why, again, the cost-to-benefit of grassfed whey is going to be in our favor because we’re getting these bioactive compounds to build neurotransmitters and they’re in a synergy of a balance of a whole food, so we’re not driving with supplementation of one compound.


And I really don’t recommend supplementing with neurotransmitters as single compound unless you’ve done advanced testing because deficiency and excess symptoms can often be very confusing. So for glutamine, for instance, one of our go-to’s is sugar cravings correlates with low glutamine. And so sugar cravings can be addressed with glutamine supplementation and using 3-5 grams under your tongue, directly under the tongue can actually help with creating GABA expression in the brain and so GABA is our neuro-inhibitory, more relaxing calming compound that blocks impulse control. And so there’s a direct correlation between these amino acid building blocks and these helping for neurotransmitter expression and they can help in also behavior management and impulse or cravings or addictive tendencies. But when glutamine gets too high in the brain, this can lead to things like brain fog, difficulty concentrating, and hyperactivity disorder, or migraines and so we can see the high glutamine is more like LGS syndrome of Chinese syndrome driving out where they can drive that hyperactivity and mania. So we get these amino acids from protein-rich foods.


Eating ample protein in the diet is the best place to start and then if we’re looking deep into trends and looking at assessments, we can then use things like tryptophan to help as intermediary compound of 5-HTP which produces serotonin. This can be very therapeutic for individuals that are not on a SSRI or a MAO medication because we don’t like to use the intermediary when we’re on a medication that expresses its receptor. So that would only be sound for people that are not using an antianxiety or antidepressant drug then 5-HTP could be a beneficial compound to add in. Now one that I do feel safe across the board recommending is L-threonine and that’s because L-threonine is not a direct building block, unlike the tryptophan which builds serotonin or the tyrosine which builds dopamine. L-threonine helps as a modulator to our neurotransmitters so this helps with the alpha waves in the brain, this helps with relaxation and concentration as well as creative thought process and focus.


And so this is one that we could bring in preemptively to help with anxiety and relaxation without overshooting any one of those neurotransmitters if we have not done advanced testing.


B: Got it. It so L-threonine, good without testing and then any of the other precursors we would do some further assessment which is what we’ll talk about in a minute.


A: Yeah and get enough protein in their diet is the first line of defense and consider using that grassfed whey to get you there.


B: Ok so let’s talk then about micronutrient focus as our final element here, and talking about anxiety, let’s just touch on pyroluria, this condition that I don’t know a whole lot about so I’m interested to hear your take.


A: Yeah it’s actually bigger in the European Union as far as large diagnostic criteria for anxiety and depression or mood and stability and it ties into basically, it’s an abnormality in hemoglobin synthesis so the making of red blood cells and there’s  a chemical imbalance where there is a buildup of cryptopyroluria, which is a compound that can be measured in the urine. And in this byproduct build-up there is a trapping and efficiency of B6 and zinc, those are the 2 most widely spoken compounds that we talk about with the pyroluria, B6 and zinc, but then we can see deficiency of biotin and GLA, or our GAMA linoleic acid. And so basically in this individual, when they’re making red blood cells which is a survival mechanism and a day-to-day production pathway, they make the excessive build-up of the cryptopyroluria and those can trap nutrients driving deficiency, which can drive mood and stability.


B: Ok and so this condition can be linked with so many behavioral issues, especially autism spectrum disorder –

A: Absolutely.


B: And it can be resolved then with just supplementation?


A: Yeah it’s actually wild, they say 4-6 weeks of getting your zinc and B6 optimized can have a huge role in regulation of this pyroluria and so something that – it’s a supplementation that has to be chronically ongoing, obviously, but supplementation can help to make up for that bound or trapped micronutrient deficiency pattern.


B: Ok wow. That’s amazing.


A: Yeah so 4-6 weeks of supplementation resolving versus chronic use of medication whether the medication uses efficacy, can cause other undesired side effects, so this is a really- a way that we can get to that root cause for sure.


B: Ok so in the same vein of micronutrients then, Ali, let’s talk finally about food, my favorite topic. So what are we looking to do just generally and then let’s do 3 food take-home ideas and then 3 supplement ideas.


A: Yes. So when we’re talking about foods, of course we want to begin by eliminating those 5 inflammatory foods so we’re talking about the gluten, corn, soy, we’re talking about the industrialized oils and the dairy foods, that’s the first place to start. And you’d want to keep those foods out for 6 weeks and then slowly introduce each grouping one week at a time. Again, you could bring in the grassfed whey at week 3 after you’ve been 2 weeks off of dairy to make sure that’s not a reaction for you. So once you’ve done that as your foundation and you’re achieving glycemic index, so you’re balancing out your carbs with protein and healthy fat, you’re making sure you’re getting ample forms of biologically available protein which means from an animal product. We want you to start there is the first place to go. So foods that are dense in your amino acids and bioavailable forms of minerals and vitamins like the zinc and B6, we’re going to see significant amounts of zinc in most meats, pasture-raised grass-fed would be best but beef, bison are great forms, even in the dark meats of your protein like your chicken and turkey, fish and salmon is a great form of zinc and then there are vegetarian forms like pumpkin seeds and cashews and nuts and seeds. Oysters are also a great form of zinc, chromium, as well as copper. And oysters are a great form of bioavailable forms of B vitamins so your B12 and B6 are another great food within there. We’d want to look at in your diet also, getting a good amount of leafy green vegetables so about 2-3 cups of leafy greens per day would be a food as medicine goal. This is going to help for regulation of folic acid, we think of foliage as far as a good to get those vitamin B’s. B’s are most highly available, in liver, and animal products, again, so looking at beef liver, looking at also doing forms of we have a recipe on the blog for a really fantastic pate, or liver pills so getting organs is a great way to get those B vitamins in the most bioavailable form.


And then we can get forms in our mushrooms so shitake mushrooms are actually a great form for both your vitamin D, which helps with mood stability and management. Vitamin D has been shown in research with deficiency trends with anxiety and depression, and then also the mushrooms are going to help with the B vitamins. And then the last family of foods I’d focus on, is going to be the glutathione. So glutathione, again, helps with that the methylation process without driving over-methylation, glutathione also helps with detoxification and reduction of free radical overload so it can reduce inflammation in the body. So glutathione is going to be highest in your indole 3-carbonyl like your cruciferous vegetables, your cauliflower cabbage, Brussels sprouts, avocado is another great source, and then the building blocks for glutathione are cysteine, so cysteine is highest seen in your biological proteins. Aldo the grassfed whey has a good amount, and then glutamine  is going to be the other building block to make glutathione. And this can be seen in our Bone Broth, so a lot of trending foods that we tend to recommend and definitely the first and foremost is keeping that glycemic balance in check.


B: Ok so let’s come up with- I’m going to challenge you, Ali, to come up with a couple of dishes where we can do this together, that incorporate these zinc-rich, B vitamins and B6-rich foods, this folate-rich foods, glutathione, and vitamin D. So what are some dishes that we could incorporate all of these or most of these in?


A: Ok so I think a really good seasonal one would be a pumpkin pie smoothie. And so this could have organic canned pumpkin, which would give us some of that zinc and vitamin A. It would have coconut milk as the base and then it would have also some pumpkin pie spices, so your warming seasonings, of course. And we would add in grassfed whey for support of the glutathione and garnish with pumpkin seeds for additional zinc. So I think that that would be a good blend of our B vitamins, our zinc, our glutathione, and would cover a good amount of balance and also it would have a nice carb-to-protein ratio using the starchy vegetable as the sweet and then if need be, you could add in maybe half of a date but that would be based on our own taste preferences.


B: Ok and then we’ve talked about liver pills a also that organ puree, or pate, can be used either as a dip for vegetables, or could be just incorporated in a small amount. I like to freeze these into little discs and add it to like a chili or soup.


A: Totally, yep so I think that’d be a great add-on there and could be an adult lunchable per say. We both like to do those for sure. And then I think a really simple third meal option is- as long as we’re getting the yolks in the eggs, that’s where the vitamin D would be and that’s where a lot of our active forms of vitamin B vitamins like choline, choline is kind of a cousin in the B family which has been shown to help with neurological health. Doing eggs scramble with vegetables would be a great thing, especially if you can incorporate some of those mushrooms and leafy greens so maybe spinach or kale and mushrooms in your egg scramble and you could hold the dairy if you’re on your 6th week of elimination and top it with some avocado for extra glutathione. Bonus points. And maybe sprinkle some pumpkin seeds on top.


B: Oh yeah. So a lot of different ways to get in foods from all of these groups and we’ll post links to any other recipes  on the show notes as well. So we’ve got a basic strategy down from this episode but where do we start in terms of supplements, Ali?


A: Yeah so there’s 3 supplements that we can start with preemptively to help with mood stability and anxiety and the first go-to would be Calm and Clear. So Calm and Clear is a favorite formula of mine, it was one of the first 5 that I came out with, and it is a synergistic blend of adaptogens and nervines so adaptogens are herbs that help us to adapt to high stress demand, so that more stressed and wired mentality, as well as nervines which help us to be more calmative so that’s also for the stressed and wired individual. And the adaptogens can work on both ends of the spectrum so adaptogens can also help the stressed and tired. The nervines especially are needed for that over-reactive excitatory distressor which is often in the anxious mindset and so it’s a blend of adaptogens and nervines so both for stressed and wired and stressed for tied and then it also has all of the B vitamins in the methylated forms to support neurotransmitter balance, ad little bit of vitamin C which is really focused on tonifying the adrenal glands as vitamin C is used in cortisol regulation, and then L-threonine and L-threonine is that modulator I mentioned for the neurotransmitters and nerves in the brain. So Calm and Clear at 3-6 capsules a day is a first line of defense. It’s the best return on your investment as far as giving your brain and body foundational health. It can be appropriate for adrenal fatigue as well as excessive cortisol output so it’s one that I feel very sound recommending to individuals and also safe with SSRIs or anxiety or antidepressant medications so one of those that’s really sound, Tonifying formula, and does have really clinical outcomes.


B: Ok and then let’s talk about my personal favorite for acute anxiety or anticipatory anxiety or anticipatory stress, GABA Calm.


A: Yeah so this is the one I took before the music class with Stella. So GABA calm is more of an immediate onset, it’s taken as a chewable and so the idea is that within about 10-15 minutes of chewing helps to get right into the brain space as a neuro-inhibitory compound, so it is a direct relaxer for excitatory stress. It just takes that white knuckle effect off of the wheel and so I’ll have – like I said, I use it personally before public speaking. It’s non-sedative so we don’t get dumbed down cognitively, we still feel very acute and alert but it really does take off that tension or any of the physical response to stress like tightness in the chest, a more racing heartrate, also can play a role with irritability is  a big one too. So more patience. A lot of people will take it a t like 4 o’clock in that transitional time to pick up kids from school, before parent-teacher conference, before a doctor’s appointments, there’s varied uses for this. GABA Calm Chews can even be used under supervision of a practitioner with children, especially of things like ADHD. So it’s a great tool, can help the trauma, can help with stress, and the nice thing is it is pretty immediate acting absolutely. So it can be used as need whereas the Calm and Clear is a foundational formula that you’re taking ongoing.


B: Yeah and the GABA Calm I’ve noticed too, I get a bit shaky when I have to give a presentation and it gets rid of those tremors literally within 10 minutes my hands will stop shaking.


A: Yeah and sometimes those of us that mentally we just muscle through the anxiety, that idea today is you don’t have to. So how can you reduce the anxiety on a physiological level and then how can you cope with it best is important as well.


B: Yes and then, Ali, let’s add one more supplement in here just for general wellness..


A: Yeah so we’ve spoken to Multidefense and that would be my third one here. And I was going between Multidefense, or the Baseline Probiotic or the EPA DHA Fish Oil, but I would choose Multidefense because Multidefense is going to give you those methylated forms of folate, methyl cobalamin, that methyl  B12 so we’re getting those active forms four B vitamins we’re also going to get in there zinc. We’re going to get our minerals that help with mood stability so we’re going to get a good blanket approach for our micronutrient needs that play a role as the regulation system for our neurotransmitter expression.


B: Got it so a really good insurance policy if it is just some kind of micronutrient imbalance or deficiency that’s driving some of the anxiety.


A: Absolutely.


B: Ok and then let’s just touch on the labs that we were talking about and some of the testing that we can do to further tailor our approach.


A: Right so if you’re already taking Multidefense or a good quality micronutrient supplement that has methylated B’s and a good food based, antioxidant- blend then you may – and you’re still dealing with symptoms and especially you have other symptoms of deficiency like changes in hair, like hair loss or weak nails or delayed recovery from exercise or inability to gain lean mass, you may consider doing our Micronutrient Blood Test and this is something that I like to run as a annual wellness assessment on all of my active patients. So if it is cost prohibitive start with at least the Multidefense as the functional micronutrient support, but if you have financial capability to do so, it’s about $350, this does look at about a 3 month average of your micronutrient status so if you’ve made a dynamic change in your diet or if you’re dealing with symptoms and you really want to get to the root cause and be more strategic with more orthomolecular treatment, meaning higher dosed treatment of micronutrients that would be a  place to start.


And then if we wanted to go past the micronutrient piece, the other thing to look into that I’ve mentioned is a neurotransmitter assessment so I would recommend the Neurohormone Complete Plus to get the entire picture to look at the progesterone and estrogen relationship. Also for men, looking at the testosterone relationships with irritability and anxiousness. Women do too but, just saying, men wouldn’t look as much at the progesterone even though they make that as well. And we would look at the Neurohormone Complete Plus for Women or the Neurohormone Complete for men. That would include sexual hormones as a salivary assessment along with the adrenal steroid hormones which is our cortisol and DHEA, so as we skimmed over in this episode, elevated cortisol can drive significant anxiety and so that hand-in-hand especially within the neurotransmitters of the epinephrine and the adrenaline pathway, can really drive that over-excitatory shakiness so looking at both the steroidal output of the adrenals as well as the neurotransmitter production tells us the whole picture of what’s going on, and then we can determine if we need to suppress or reduce cortisol expression, if we need to support the adrenals and help with productivity, and then on the neurotransmitter side, whether it is sound to work with something like 5-HTP or L-tyrosine, or glutamate and how we can target and approach on a therapeutic level to really get best clinical outcomes.


B: Got it so just to put some of this in order for listeners or kind of organize our thought process here on terms of where to start so really that foundational focus using those 3 base supplements as tools to get above the water, if you will, and then it sounds like we’d go into elements of dysbiosis if we’re dealing with that bloating, distension or bacterial influence. And then the next line of defense would be really focusing on production of neurotransmitters, supporting the diet with the nutrients that are required.


A: Yep. Absolutely and if inflammation and glycemic index are not managed, it’s going to be difficult to get outcomes so this works as a really beautiful synergy because as you reduce the inflammatory foods and you lower your glycemic index, lowering your glycemic index helps to starve off the dysbiotic or overgrowth of bad bacteria and also by regulating your glycemic index you’re probably bumping up you biological protein intake which means likely you’re getting more amino acids, zinc, and B6 so we’re going to be getting more of the therapeutic building blocks with less of those inflammatory irritants.


B: Ok so I think we’ve covered a lot of really good tools for listeners in terms of getting started with holistic management, if you will, of anxiety and managing it from a whole body perspective. So we’ll put our links out, as always, in the show notes to this podcast so that’s found at and just remember, start these steps one at a time, breathe through the process, and we are absolutely here to support you and work with you on this journey.


A; Yes it’s always about what you can manage, don’t allow this episode to create pending stress, right? So think about where you can start, maybe you heard one or 2 a-ha moments and then commit to those and it’s a layering process so we’re so honored to be a part of your journey and please keep us updated on how you’re doing with the process.


Thank you for listening to the Naturally Nourished Podcast. Visit our blog at for recipes, wellness tips, and food as medicine meal plans. Connect with Ali at Becki at AliMillerRD on InstaGram or Twitter and Facebook. Until next time, stay nourished and be well.


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