alcat test_food allergy and chemical sensitivity tests
DESCRIPTION
If you think you are allergic to any kind of food, then use our Food Allergy testing procedure to determine the food that is not for you. With a food allergy test, you don’t have to down something that you can’t take also called Food intolerance! Food sensitivity can be dangerous. You won’t know it, but it might end up being your worst foe! for more details visit https://www.alcat.com/TRANSCRIPT
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Anxiety and Your PatientA holistic, integrative approach for the general practitioner-
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EpidemiologyJournal Clinical Psychiatry- most
common psych disorder15.7 million in the US 30% seek treatmentPresent to general practitioners
more than psychiatrist
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What is AnxietyPersistent fear response without
identifiable specific trigger orProlonged responseStarts fight or flight response Anxiety increases risk of
inflammatory diseasesMore prone to mistakes, less
productive
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Genetic? Studies show may be genetic
susceptibility with variants of retinoid-related orphan receptor alpha (RORA) gene to PTSD
Gene primary function to protect brain from stress
Gene Variant of BDNF gene Met66Met- smaller hippocampus on imaging and higher response amygdala to emotional stimuli with fMRI (Val66Val calmer)
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Mediators- B.I.GBrain (neuroendocrine)Immune System- surveillance, Gut Vagus nerve 2 way
communication system between brain and gut
All interact to form super information highway
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Brain-Theories and Substances
TriggerArrives amygdala To Locus CereleusActivation of sympathetic systemPrefrontal lobeResponse
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Brain Connection- Pathway r
Trigger
Amygdala
Locus Cereleu
sNE
CRH
ACTHAdrenal
Stimulation
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Theories and SubstanceAmygdala stores fear memoriesUsed Pavlovian conditioned and
unconditioned stimulus Substances affect amygdala can
escalate or ameliorate anxiety
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Brain ConnectionLocus Cereleus primary NE
center in brainLC can be affected by other NTLC connects to all parts of brain
including hypothalamusNE play role in HTN, behavioral
changes and modulates HPA axisIncreased cytokines increase NE
in hypothalamus via LC neurons
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Brain ConnectionSeveral factors seem to play a
role hereNT such as GABA, Serotonin and
Norepinephrine and glutamate have been assigned significant roles
The HPA with CRF axis gets activated as well
Cytokines can form de novo in the brain and trigger responses
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Brain Connection The major neurotransmitters
implicated in the anxiety response
GABANESerotoninGlutamate
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Brain ConnectionSerotonin is known as inhibitory
NTDerived from trytophanMajority found in gut (90%)Rest brain and plateletsFoods that irritate gut can caused
excess release of serotonin leading to diarrhea (goal is to expel substance causing issue)
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Brain ConnectionSerotonin depletion in prefrontal
cortex leads to anxiety symptomsSerotonin has 7 subtype
receptors5HT1a- related to anxiety5HT3 in the chemoreceptor
center brain can be stimulated by excess serotonin and cause nausea and vomiting
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Brain Connection GABA major inhibitory in the
brainAlso found in GutRegulation of GABA system in
amygdala important part of anxiety pathology
Pathway conversion excitatory Glutamate to GABA via enzyme glutamate decarboxylase
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Brain Connection- GABA 3 types GABA receptors- A, B. CDeficiency in GABA receptors (A)-
led to hyper activation of HPA axis
GABA-A (fast)– binding increase cl conductance so hyperpolarize post synaptic neurons to decrease excitation
GABA-B- inhibit Ca channels to reduce NT release, and K channels to decrease excitability
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Glutamate
Excitatory NT (most abundant)Several studies indicate that
modulating glutamate receptors can improve anxiety
Mechanism not fully elucidatedGlial cells responsible removal of
glutamate Dysfunction or reduction leads to
glutamate toxicity
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GlutamateThought to be mediated through
NDMA receptorNeeds glutamate, glycine and
voltage for activation and opening channels
Open- Calcium influxExcess calcium- neuronal injuryFine line because activation
NDMA needed for memory and learning
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NorepinephrineIncreases symptoms of anxietyWhen administered symptoms of
anxiety- HR, diaphoresis, etc.Controversy if NE from LC
causative
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Brain Connection- Other substances CCK 4- provokes anxiety BDNF- responsible for health,
growth and plasticity of nerves (adaptability)
BNDF protects neurons from glutamate toxicity
Oxytocin- role in social phobias
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Brain Connection- BDNF Human study showed depressed
individuals with lower BDNFThose with lowest BDNF levels
did not respond as well to anti-depressant treatment
Several studies show BDNF facilitates function of anti-depressant esp. SSRI
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Immune ConnectionThe immune system is thought to be
trigger Chronic GI inflammation increases
inflammatory cytokines and anxiety behavior
Immune system and neuroendocrine share many receptor sites and ligands
Cytokines (produced by immune system and also by brain) can regulate stress response in brain as well as endocrine system and behavior
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Immune connectionImmune system when triggered
produce cytokinesEx. IL-6, IL-1, IL-2, IFN-gamma, TNF,Peripheral cytokines can cross BBBStimulate HPA axis as well as cause
brain (glial Cells) to produce de novo cytokines
Excess IL-6 act on neurons increase anxiety and cognitive deficits
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Immune ConnectionCytokine can activate HPA axisIncrease CRHCRH sensitize cells and facilitate
effect of cytokines like TNFTNF alpha injected in amygdala
facilitated ETOH withdrawal anxiety
Inhibitor of CRH receptor decreased magnitude of anxiety response
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Immune ConnectionInterferon gamma stimulates
enzyme indoleamine2,3 dioxygenase (IDO). This degrades Tryptophan (responsible for serotonin formation) to other inflammatory substances such as Kynurenine
17 B-estradiol could increases INF gamma thereby potentially increasing inflammation
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Immune ConnectionAging increases Cytokines such as
INF gamma, TNF alphaDysregulates HPA feedback
mechanism thereby increasing cortisol levels
Cortisol affects metabolism of tryptophan towards inflammatory along with direct effect hippocampus
Theorized one of reasons elderly more prone to depression/anxiety
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Immune ConnectionStudies show that TCA like
imipramine and SSRI have anti-inflammatory effect
Decreases levels of IL-2, IL-1, TNF, IL-6, INF gamma
These substances have immediate effect on NE and Serotonin but takes longer for clinical benefits (about time that it takes to have effect on cytokines
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Gut ConnectionGut has over 100 million neurons90% visceral neurons have
connection with brain95% all serotonin found in gut
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Gut ConnectionStudies showed that changing
bacterial flora in mice changed behavior
Colonized germ free mice with gut flora from active or passive mice would change behavior accordingly
Mice treated with antibiotics- anxiety reduction.
Stopped antibiotics flora and anxiety returned to baseline
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Gut ConnectionChanges seem to be associated with
change in BDNF (linked to anxiety and depression)
Stressor exposure changed bacterial flora in gut (decrease genus Bacteroides and increase Clostridium)
Stressor also increased inflammatory cytokines (IL-6, MCP-1) further affected other bacterial flora
IL-6 inflammatory cytokine
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Gut ConnectionEvidence that Lactobacillus
Rhamnosus augments GABA function in brain via vagus nerve from gut (results lost with vagotomy)
Also lowered corticosterone levels
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Gut ConnectionInfectious colitis induces anxiety
Bifidobacterium longum NCC3001 improved anxiety (results lost with vagotomy)
Bifidobacterium longum normalized behavior and BDNF mRNA but did not affect cytokine or kynurenine levels
Enbrel- decreased cytokines and improved anxiety but did not affect BDNF
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Gut ConnectionSince inflammation can directly
affect flora of gut and flora can affect behavior
Could anything such as food sensitivities cause inflammation in gut and thereby exacerbate anxiety symptoms
Personal food sensitivity such as ALCAT may be an important adjunct as testing looks at immune response to foods
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Gut ConnectionStudy showed stress contributed
to development of food allergies by increasing gut permeability therefore increased uptake of food antigen
Bacteria like H. Pylori has been shown to do the same in gastric mucosa, also increasing food sensitivity
Activation of immune system and cytokines
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Gut Connection Food sensitivities trigger gut
permeabilityPart treatment remove triggersHeal gutBifidobacterium Animalis Lactis
LKM 512 found to help to keep tight junction gut and decrease permeability
Decreased inflammation in elderly
Seems to suppress inflammatory bacteria
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What to do?When and if possible identify triggerGut symptoms- know can be variety
of things from food sensitivity, to infectious or inflammatory trigger such as IBD to emotional stress (remember changes flora)
ALCAT may be helpfulRemove and or treat triggerConsider probiotics with
neuromodulatory effect
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What to doConsider other substances to
decrease inflammatory cytokines while treatment is on going (curcumin, fish oil, and resveratrol, andrographis)- ?medical food
Tea Tree Oil (inhalation)- decreases TNF alpha, IL 1
If over weight start weight lossRemember Adipocytes can
generate cytokines as well
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What to doGerman Chamomille- inhibited
release lipopolysaccharide which induce macrophage prostaglandin E2 (LOX-2 inhibitor
Maybe possess some anti-microbial properties (gut dysbiosis)
Contains Apigenin flavonoid- study show mild sedative via inhibition NDMA-R
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What to doI have found neurotransmitter testing
helpfulEven though no info on receptors,
etc. I find it helps me to chose supplements or meds
Check for easy nutrient deficiencies B12, folate, red blood cell magnesium (easier than loading test)
Check cortisol/ACTH levels - helps in choosing tx
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What to do- herbalValerian- blocks glutamate
receptorJujube (Ziziphysis Spinosa)-
inhibits glutamate receptor to decrease excitability
Kava- shown to improve anxietyConcern with liver issues due to
quality of Kava, parts used and inappropriate dosage
Passion Flower extract – thought to have GABA agonist properties
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What to doTryptophan- just remember that
inflammation can turn a good AA bad
Studies do not support St. Johns Wort for anxiety
Magnesium- modulates NDMA-R slow influx calcium- protecting neurons
Vitamin B12 studies show protects neurons NDMA-R glutamate toxicity
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What to doL-Theanine- studies suggests works
thru GABA- A receptorsOther studies show affect on
serotonin and dopamine NTPersonally noted that if dopamine
on NT test high, theanine may have slightly anxiogenic affect
Good news- neuroprotective by decreasing formation glutamine to glutamate
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What to do- HPA AxisLavender Essential oil stimulates
PNS to decrease excitabilityLemon Balm- inhibitor of GABA
transaminase (enzyme clears GABA)
Address HPA axisStress managementCognitive therapy (enhanced with
D-cycloserine for specific phobias)
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What to do-HPA Magnolia officianlis (honokiol and
magnolol)- decrease corticosterone, increase 5HT in hippocampus, antimicrobial, decrease TNF alpha
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What to doIf menopausal consider there
may be a hormonal componentChanges in hormones such as
estrogen, progesterone and testosterone can contribute to anxiety symptoms
I could correct other issues first to optimize results
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What to do- Hormones Several studies suggest estradiol
can be anxiolyticEstrogen increases the mRNA for
trytophan hydroxylase enzyme (rate limiting step in production of serotonin
Effects in dorsal raphe and seems to occur binding ER beta
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What to do- hormones Can increase proinflammatory
cytokines Avoid with autoimmunity? One study suggest this effect
may be at least in part influenced by presence of hydroxylated estrogens (2,4,16) and cortisol
Personal approach r/o autoimmunity, correct inflammation if present before this step
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What to do- Hormones Progesterone- anxiolytic or
anxiogenicSeveral studies suggest that
effect on GABA receptorsConversion to allopregnanelone
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What to do- Pharmacological SSRI, 5HT1a-R agonist- decrease
inflammation, increase serotonin (E.g. Lexapro, Buspar)
Also seem to modulate NDMA-RBenzodiazepene- GABAB-Blocker (Inderal)- performance
anxiety (stage fright, exams, etc.)Block sympathetic symptoms, also
acutely decrease endorphin levels
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Some ConcernsProlonged use SSRI can lead to
osteoporosisShown eventual decrease in
serotonin levels below baseline with chronic use
Benzodiazepenes addictive potential
Long term effect of beta blocker- depression, memory loss etc.
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What to AvoidSpirulina- increases, TNF alphaEchinaccea- can potentially increase
IL-6, TNF alpha?? Honey- works by increasing TNF
alpha, IL 6, IL 1Remember cytokines can stimulate
HPA axis as well as activate amygdala and LC =NE anxiety
Caffeine blocks its receptors adenosine that slows HR and calms-
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THANK YOU
For more details visit https://www.alcat.com