Anxiety is characterized by the fear or worry that something bad will happen, normal anxiety occurs occasionally in response to situations that threaten our sense of security.
Frequently Asked Questions
- 1What is anxiety?
- 2What are the different types of anxiety?
- 3What are the risk factors for anxiety?
- 4What are the causes of anxiety?
- 5How is Anxiety disorders diagnosed and treated?
- 6What integrative measures are recommended to treat Anxiety?
- 7What natural therapies may help with anxiety?
- 8Why should one not self-medicate?
- 9How do I get started?
- 10How is anxiety managed at Health Renewal?
- 11How do we treat this at Health Renewal?
- 12What should you bring along to your appointment with your Health Renewal doctor?
- 13What is the cost of the extended consultation with the Health Renewal doctor?
- 14How often should I see the integrative Doctor?
- 15Health Renewal tip:
- 16Health Renewal's 10 Inspiring Quotes For Healthy Living:
- 17Health Renewal Tip: What can you do to control and prevent anxiety?
As nature intended it, anxiety serves a useful purpose. Characterized by the fear or worry that something bad will happen, normal anxiety occurs occasionally in response to situations that threaten our sense of security. This helps us avoid harm and remember not to put ourselves in the same potentially dangerous situation in the future. Anxiety is a normal stress response that has been conserved throughout human evolution and is evident in all other animals. However, when anxiety occurs inappropriately in response to normal everyday events, it can become a debilitating condition known as anxiety disorder. Anxiety disorders cause a person to be constantly “primed”, or “tense” in expectation of an impending threat to their physical or psychological well-being. Symptoms of anxiety disorders are often chronic, and can include:
- Difficulty concentrating,
- tense muscles,
- sleep disturbances, and
- trouble overcoming worries.
The conventional health care model typically attempts to alleviate anxiety with an array of psychoactive drugs that either mimic or manipulate neurotransmitter signaling. For instance, medications for anxiety might either increase the recycling of existing neurotransmitters or bind directly to neurotransmitter receptors and block or activate them, artificially altering mood. However, psychoactive drugs fall short of addressing the underlying causes of anxiety – hormonal and metabolic imbalances that emerge as our bodies attempt to adapt to chronic stress.
Recognizing and responding to underappreciated risk factors for anxiety disorders, such as elevated homocysteine and sex hormone imbalances, is an important aspect of any treatment regimen. Sadly, mainstream physicians often fail to address these subtleties, an oversight that undoubtedly contributes to the paltry 50% success rate of conventional anxiety treatments. Anxiety is a multifaceted disorder, and must be addressed as such in order to achieve symptomatic relief. Clinical studies indicate that nutrients such as omega-3 polyunsaturated fatty acids, magnesium, and adaptogenic herbs like rhodiola can synergize with healthy eating habits and stress management techniques to effectively optimize the body’s stress response mechanisms and support healthy neurological communication. Moreover, compounds such as B-vitamins and amino acids can provide the raw materials the body needs to ensure proper neurotransmitter synthesis and signaling.
Nearly 15% of adults will experience an anxiety disorder in their lifetime. It’s interesting to note that depression and anxiety are very much interrelated. For up to 90% of all cases, anxiety disorders generally develop early in life—before the age of 35 with the greatest risk of onset between ages 10 and 25. Also, women are twice as likely as men to suffer from generalized anxiety disorder. The latest statistics suggests that an imbalance in female hormone levels during and after menopause, during menstruation, and after pregnancy may be tied to the etiology of anxiety.
- Generalized anxiety disorder.
- Generalized anxiety disorder (GAD) is characterized by worry and tension in the absence of a real provoking environmental factor. A person with GAD is constantly apprehensive, anticipating disaster, and becoming overly concerned about their health, finances and work without cause. People with GAD are frequently unable to relax and battle insomnia and poor concentration. Other symptoms may include restlessness, fatigue, irritability, muscle tension, high blood pressure, and sleep disturbances. Many people with mild GAD often manage to maintain their careers and function socially. However, severe cases can lead to job failure and avoidance of social situations. Physicians diagnose GAD based upon the following criteria – an individual worrying excessively about everyday problems and exhibiting three or more GAD symptoms, on most days, for at least six consecutive months.
- Panic disorder
- Panic disorder is characterized by sudden attacks of fear and the sense of impending doom. A panic attack can cause elevated heart rate, sweating, dizziness, fatigue, shortness of breath, nausea, chest pain, and feelings of being cold and numb. In many cases these physical symptoms exacerbate the panic attack as the person may feel like they are dying or in terrible physical danger. Panic attacks are often unpredictable and come on suddenly, but can be triggered by exposure to stimuli associated with past trauma, such as driving through an intersection where the person was involved in a major car accident. Panic attacks typically last about ten minutes. Episodes often appear without warning and with varying frequency. Panic disorder is very disabling, causing people to avoid places or situations that caused attacks before. As a result, people with panic disorder often lose their jobs or change their residence. Nearly one third of people with panic disorder will become fearful of leaving their homes and develop agoraphobia, a fear of open spaces. The clinical definition of panic disorder is when a person experiences recurrent, unexpected panic attacks, at least one of which is followed by one or more of the following: persistent concern about future attacks, worrying about the implications of the attack, and/or a significant change in behavior related to the attacks.
- Obsessive-compulsive disorder
- Obsessive-compulsive disorder (OCD) is characterized by persistent, upsetting thoughts (obsessions) that can lead to anxiety and the use of ritualistic actions (compulsions) in an attempt to alleviate this anxiety. A good example is a person obsessed with the presence of bacteria in the environment. In this case, a person with OCD may develop a compulsion to ritualistically and repetitively wash their hands, or engage in some other type of self-cleansing. The person with OCD does not find performing the ritual pleasurable, but it instead provides temporary relief from the anxiety. While healthy people can demonstrate repetitive behaviors, such as double checking to see if the doors are locked, people with OCD perform rituals so repetitively that their behavior distresses them and can interfere with the performance of everyday tasks. Eating disorders, other anxiety disorders, and depression commonly accompany OCD. Recent research shows OCD affects men and women equally.
- Phobias are inexplicable and unjustifiable fears. Phobias may be a fear of certain objects or things. Social phobia, also known as social anxiety disorder, involves excessive self-consciousness and anxiety about everyday social situations. People with social phobia are chronically fearful of embarrassing themselves and being judged by others. They can experience dread weeks before a scheduled encounter or interaction, which may can interfere with everyday activities. Physical effects associated with social phobia can include blushing, sweating, nausea, and difficulty speaking. Other anxiety disorders and depression may accompany social phobia. The clinical definition of social phobia is when a persistent fear of social situations causes people to either avoid them or experience them with great anxiety.
- Post-traumatic stress disorder.
- Experiencing or witnessing a traumatic or terrifying life event such as a serious accident, violent crime, or natural disaster can precipitate a post-traumatic stress disorder (PTSD). People with PTSD may either relive the event in nightmares or have disturbing recollections of it during waking hours. Ordinary events can trigger flashbacks that may result in a loss of reality, causing the person to believe the event is happening again. PTSD can occur at any age. Symptoms associated with PTSD can include an inability to sleep, hypersensitivity to external stimuli, feelings of detachment or numbness, and loss of memory surrounding the traumatic experience. Physicians diagnosing PTSD consider whether the patient persistently re-experiences the traumatic event through memory, dreams, hallucinations, flashbacks, or physical reactions to internal or external triggers. For a diagnosis of PTSD, symptoms must be present for more than one month- but may occur years after the traumatic event.
A variety of factors can increase the risk of anxiety disorder. Being female is a risk as it affects twice as many women than men. Age is another factor, with the greatest risk of onset affecting those between the ages of 10 and 25. Research shows children who are shy or likely to be the target of bullies are at a higher risk of developing anxiety disorders later in life. Anxiety disorders also tend to run in families, believed to have both a genetic and learned component. Lack of social connections, traumatic events, and certain medical conditions are also associated with an increased risk of anxiety disorders. Anxiety can occur independently of or in conjunction with other psychiatric or medical conditions such as depression, chronic fatigue, cardiac disease, or respiratory compromise. Chronic anxiety is associated with a higher risk of illness and death from cerebrovascular and cardiovascular diseases such as hypertension, cardiac ischemia and arrhythmias. Also, chronic anxiety predisposes people to a range of neurological disorders. People with anxiety disorders are less able to deal with life’s occasional blows. Divorce, financial disaster, or other severe stressors may increase their risk of suicidal behavior.
Homocysteine is an intermediary within a metabolic cycle known as methylation. Methylation reactions, relying largely on B-vitamin cofactors (particularly, B6, B12, and folic acid), are critical for the proper synthesis of the neurotransmitters that play an important role in mood regulation. As B-vitamin levels decline, the methylation cycle becomes impaired-leading to a concurrent increase in homocysteine levels (because it is no longer being recycled efficiently) and a disruption in neurotransmitter synthesis. The close relationship between neurotransmitter synthesis and homocysteine formation has lead some researchers to suspect that there is a link between homocysteine and mood. Indeed, studies suggest that levels of homocysteine are an effective marker for B-vitamin status, and that changes in homocysteine levels correlate with changes in mood. Interestingly, homocysteine levels have predicted duration of PTSD, suggesting that lowering homocysteine levels through supplementation with B-vitamins might reduce symptoms of mood disorders by freeing up metabolic resources involved in neurotransmission. Other studies have clearly tied genetic abnormalities such as a mutation in the folic acid-activating enzyme, MTHFR, to high homocysteine levels (and increased symptoms of mood disorders). This reinforces the notion that homocysteine metabolism is an important target in psychiatric imbalances. Studies showed that supplementation with homocysteine-lowering B vitamins was shown to relieve anxiety in 44 women with premenstrual anxiety.
Another compound involved in the methylation cycle is S-adenosylmethionine (SAM-e). SAM-e functions to donate methyl groups into the methylation cycle thereby facilitating the formation of neurotransmitters such as dopamine and serotonin. In some clinical trials, SAM-e supplementation has been shown to be as effective as tricyclic antidepressants in treating depressive disorders. Given the role of healthy methylation in maintaining biochemical balances within the central nervous system, a target blood level of less than 7 μmol/L of homocysteine helps to ensure proper neurotransmitter metabolism and may balance mood during times of stress, depression and anxiety.
If you have an impaired stress response it can lead to Anxiety, Depression, and the hypothalamic-Pituatary-Adrenal Axis.
It is very rare that an anxiety disorder manifests by itself and alone. What happens more often is that anxiety will be accompanied by other mood disorders, particularly depression. In fact, depression and anxiety can both be viewed as manifestations of impaired stress response, the underlying physiology of which are both very similar. When an individual experiences a stressor, physical or emotional, internal or environmental, the body initiates a complex system of adaptive reactions to help cope with the stress. This reactive response involves the release of glucocorticoids, also known as stress hormones, which stimulate adaptive changes in a variety of bodily systems. Under short-term circumstances, stress-induced changes prioritize functions involved in escaping danger such as redirection of blood flow to the muscles from most other body parts, dilation of pupils, and inhibition of digestion for energy conservation. During this time, fatty acids and glucose (blood sugar) are liberated from storage sites into the bloodstream where they are readily available for utilization by the muscles. This is known as the fight-or-flight response. This reactive and adaptive protection system originates in the brain. When a threat is perceived by the hypothalamus (a brain region), chemical signals are sent to the pituitary gland (another brain region). The pituitary gland then sends chemical signals to the adrenal glands (endocrine glands atop the kidneys), which in turn releases the stress hormone cortisol. Cortisol then goes on to initiate many of the physiological changes that allow the organism to respond to the impending danger. The fight-or-flight response is shared among nearly all animals in that the need to escape from imminent danger is paramount for the survival of the species.
However, modern humans live in an environment filled with emotional stressors, such as financial worries, deadline pressures at work or school, as well as unnecessary physical stressors such as excessive caloric intake, obesity, and inactivity. All of these modern stressors chronically activate the hypothalamic-pituitary-adrenal axis, leading to adverse health consequences such as increased rates of cardiovascular disease, diabetes, and mood disorders like depression and anxiety. The relationship between chronic stress, depression, and anxiety is complex and incredibly powerful. The chronic elevations in glucocorticoids (primarily cortisol) caused by excessive stressors in industrialized societies lead to actual physical changes in brain structure. For example, dendrites, the branches of neurons that receive signals from other neurons, are shifted into less functional patterns upon chronic exposure to glucocorticoids. This has been documented in key brain regions associated with mood, short-term memory, and behavioral flexibility.
Furthermore, glucocorticoids cause receptors for the mood-regulating neurotransmitter serotonin to become less sensitive to activation. Other detrimental effects of chronic stress include both increased susceptibility to neuronal damage and impaired neurogenesis, the process by which new neurons are “born”. Interestingly, emerging research suggests that psychoactive drugs, like those used in anxiety and depression, may stabilize mood not only by acting upon neurotransmitter levels, but by modulating the action of glucocorticoids receptors in the brain itself. These new findings strongly support the idea that in order to alleviate mood disorders, controlling stress response is an important aspect of treatment. Indeed, several genetic and epidemiological studies have linked excessive stress, and the inability to efficiently adapt to stress, to increased rates of anxiety and depression.
Anxiety and depression may have similar or even overlapping symptoms, therefore diagnosis and treatment of anxiety disorder can be very difficult. It is very possible that a person can swing back and forth between anxiety and depression. However, as many of the same neural mechanisms are involved in both conditions, sometimes treatment for one can be effective for the other. There are several screening tests available to help determine the cause, type, and severity of anxiety, but the diagnosis of anxiety disorders remains somewhat subjective and is based on observation & clinical findings. Once a doctor diagnoses an anxiety disorder, treatment will often integrate several approaches, including but not limited to diet and lifestyle changes, relaxation and massage therapy, psychotherapy, behavioral or cognitive-behavioral therapy, and drug intervention.
- Cognitive-behavioral therapy involves modifying thought patterns that influence anxiety and fear. It helps the patient recognize cognitive distortions, exaggerated and irrational thoughts that produce reactions such an anxiety and panic. Special tools then help the person detect distorted thinking and replace distorted thoughts with more accurate ones. Cognitive-behavioral therapy is a first-line treatment and is effective in treating all anxiety disorders.
- Behavior therapy uses several techniques such as diaphragmatic breathing exercises and exposure therapy. Diaphragmatic breathing teaches people how to control the physical signs of anxiety by taking slow, deep breaths to help control hyperventilation. Exposure therapy relies on small, progressive exposures to the frightening trigger, helping people build confidence and control anxiety.
- Drug therapy is often used in combination with psychotherapy to manage the biochemical and physiological abnormalities that produce anxiety, including alterations in the levels of serotonin, norepinephrine, and cortisol (the stress hormone). Pharmaceutical treatment of anxiety disorders involves manipulating or mimicking the action of neurotransmitters within the brain (typically GABA and serotonin; but sometimes dopamine and norepinephrine). However, these drugs usually do not resolve the over-activation of the hypothalamus-pituitary-adrenal axis that often underlies mood disorders. Using medications to try to improve brain chemistry can offer relief, at least in the short term. However, medications neither restore normal levels of neurotransmitters, nor promote normal brain function. Instead, they manipulate the brain chemistry to achieve their desired effects. Over time, the brain can get used to medications, resulting in them losing their effectiveness and requiring either higher doses or different drugs. The following are some of the drugs frequently prescribed to treat anxiety disorders:
- Benzodiazepines act in part by modulating and extending the life of gamma-aminobutyric acid (GABA), an inhibitory (calming) brain neurotransmitter. Benzodiazepines can relieve anxiety symptoms quickly. However, they can become habit forming. Some people develop a tolerance to them, requiring an increased dosage. When benzodiazepines are reduced or removed, some individuals can experience withdrawal symptoms, such as confusion, memory loss, hyper-anxiety, and reemergence of the original symptoms. While these drugs are highly effective in calming anxiety, they may also be habit-forming, if used long-term – a factor that dramatically limits their usefulness and possibly their long-term safety.
- Antidepressants are sometimes effective for treating anxiety, especially when it occurs in conjunction with depression. Types of antidepressant drugs include selective serotonin reuptake inhibitors (SSRIs) as well as the less common tricyclic antidepressants (TCAs).
- Beta-blockers such as Propranolol or Atenolol are used primarily to treat heart conditions. However, they are often prescribed for social phobia to help reduce heart palpitations as well as other physical symptoms of anxiety. Side effects can include slow pulse, drowsiness, fatigue, dry mouth, numbness or tingling of fingers or toes, dizziness, weakness, and cold hands and feet.
- Pregabalin is an anticonvulsant drug that is sometimes used to treat anxiety. Its effects become apparent quickly, some studies suggest within one week. Also, it appears to be effective in preventing a relapse of anxiety disorder as well as helping ease withdrawal symptoms after discontinuation of benzodiazepine therapy. This drug often causes dizziness, drowsiness & weight gain.
Anxiety & Hormones:
Anxiety disorders affect twice as many women as men. Further, women experience more anxiety when they are pregnant, postpartum (after giving birth), premenstrual and menopausal than at other times in life. This general observation has lead scientists to investigate a hormone-anxiety link. By now, it is well known that most steroid hormones (e.g., pregnenolone, estrogen, progesterone, testosterone, and DHEA) are neurologically active. In fact, large quantities of DHEA, estrogen, progesterone, and testosterone receptors are found in the brain. These hormones affect the brain in a number of ways, including regulation of mood.
A number of studies have linked abnormalities in hormone levels to various anxiety disorders. Studies suggest that levels of estrogen and serotonin may be linked, both affecting a positive mood during menstruation in young women.
Likewise, the drop in estrogen during menopause, associated with reduced serotonin production, has a negative impact on mood and cognitive function. Progesterone also plays a role in anxiety. In a placebo-controlled trial involving post-menopausal women, hormone replacement therapy using both estrogen and progesterone caused a marked reduction in anxiety, as well as improved sleep quality and better cognitive performance. Bioidentical hormone replacement therapy (BHRT) is an ideal method to restore youthful hormone levels for aging individuals. BHRT involves supplementation (usually) with either transdermal (topical) or oral preparations of hormones obtained from a compounding pharmacy. BHRT differs from conventional synthetic hormone replacement therapy (HRT) in that it relies on the use of natural hormones whose molecular structure exactly matches those of the hormones produced within the human body.
In a clinical trial conducted at the University of Texas, nearly 300 women with an average age of 52 years were treated with bioidentical progesterone and/or estrogen. After six months of BHRT, women aged 40 – 70 years old experienced dramatic improvements in mood, including a 31% reduction in emotional ability, 37% reduction in irritability, 33% reduction in anxiety, and significant relief from night sweats and hot flashes. Moreover, of the women screened for heart attack or breast cancer an average of 1.9 years after beginning BHRT (21% of the cohort), none of them had either. Just as the female brain depends on healthy levels of estrogen and progesterone to function normally, the male brain depend on sufficient testosterone. Low testosterone levels can cause testosterone deficiencies in the brain, thereby impairing brain function leading to depression and anxiety. In humans, increases in testosterone levels seen during DHEA therapy have been linked to reduced anxiety. Laboratory studies indicate that activation of the androgen receptor by testosterone may reduce anxiety through interaction with GABA receptors. Normalizing hormone levels can be an integral part of managing anxiety disorders.
Of course, it is also important to address the factors that cause hormonal imbalances in the first place. These include blood sugar dysregulation, oxidative stress, inflammation, and other disruptions in metabolic function leading to chronic stress, a condition that frequently results in both hormonal imbalances and anxiety disorders. In addition to managing hormonal imbalances, it is important to examine the relationship between the stress hormone cortisol and DHEA (a building block for the sex steroid hormones). During times of prolonged stress, a greater proportion of cortisol is made compared to DHEA, with a high cortisol to DHEA ratio being a marker associated with anxiety disorder. DHEA counteracts some of the negative impact of cortisol in the body. Clinical studies have found DHEA supplementation to be particularly helpful in relieving anxiety in both schizophrenics and females with low hormone levels. It is important to note that all the major sex hormones are interrelated. Thus, people with anxiety may benefit from comprehensive hormone testing, and if necessary, a program of bioidentical hormone replacement.
People with anxiety disorders can take a number of steps to reduce their symptoms. Smoking, alcohol and caffeine consumption, lack of exercise and an increased Body Mass Index (BMI) can all have a negative impact on the degree to which aging individuals experience anxiety.
Getting enough sleep and exercise, maintaining a healthy body weight, and moderating caffeine consumption on the other hand are recommended for reducing anxiety.
Recent clinical trials demonstrate the benefit of yoga, Tai Chi & Pilates. Most compelling was a study using brain scans showing a significant increase in thalamic GABA activity, which correlated to a better mood after the practice of yoga. Tai Chi and yoga have been shown to reduce anxiety and heart rate after each 20-minute session. In one study, two-months of yoga classes reduced stress symptoms in women with anxiety disorder. Music and massage therapy appear to be particularly helpful in reducing anxiety associated with postoperative stress and treatment for cancer.
Healthy cooking and a nutritious diet are central to controlling anxiety. In a study involving over 10,000 people, following a Mediterranean diet lead to reductions in mood disorders. When it is not always possible to have a well-balanced diet, nutritional supplementation can be an important lifestyle factor in the fight against anxiety.
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In general, a healthy diet is abundant in omega-3 fatty acids, organic fresh fruits and vegetables, filtered water, and devoid of foods high in saturated fats and refined carbohydrates. This dietary pattern resembles the Mediterranean diet. In addition, the following nutrients may support healthy stress response and help balance brain chemistry naturally:
- Amino Acids:
When the brain produces a neurotransmitter, it starts with a raw ingredient-usually an amino acid from the diet or another chemical already present in the brain. Enzymes are then used to convert the amino acid into the needed brain chemical. By understanding this process in detail, we can take measures to ensure an ample supply of the raw ingredients and enhance the activity of the enzymes. There are various cofactors that help the enzymes work faster; B-vitamins, for example:
L-tryptophan, 5-HTP. Insufficient intakes of L-tryptophan, L-phenylalanine, or L-tyrosine are associated with increased symptoms of anxiety. Supplementation with L-tryptophan or 5-hydroxytryptophan (5-HTP) has been shown to elevate brain serotonin levels and enhance both mood and one’s sense of well-being. Vitamin B6, magnesium, and vitamin C, nutrients already taken by most health-conscious people, are cofactors that facilitate the conversion of tryptophan to serotonin in the brain. As people age they produce more of an enzyme that degrades tryptophan, even if taking tryptophan supplements. Lysine, niacinamide, and anti-inflammatory nutrients such as rosemary have been shown to neutralize the effects of this enzyme and help preserve the synthesis of serotonin from tryptophan. D,L-phenylalanine and L-tyrosine taken with a carbohydrate-rich meal can increase synthesis of dopamine and norepinephrine. There are no reported adverse effects, but pregnant women and individuals taking MAOIs should avoid high doses.
L-lysine. An L-lysine deficiency has been shown to increase stress-induced anxiety in humans. L-lysine binds to a serotonin receptor, acting as a serotonin antagonist by inhibiting serotonin reuptake in the synapse. When presented with a stressful situation, supplementation with L-lysine reduced anxiety in human subjects.
L-Theanine. Theanine, an amino acid found in green tea, produces a calming effect on the brain. Theanine easily crosses the blood-brain barrier. It increases the production of GABA and dopamine and protects the cells of the hippocampus, the seat of learning and memory in the brain from damage. In an 8-week study involving 60 schizophrenic patients, 400 mg of theanine was added to standard antipsychotic therapy. The addition of theanine significantly reduced anxiety and improved several other measures of mood beyond what was achievable with pharmaceuticals alone.
S-Adenosylmethionine (SAM-e). SAM-e occurs naturally in the body. It is concentrated in the liver and brain and is a major methyl donor in the synthesis of hormones, nucleic acids, proteins, phospholipids, and catecholamine neurotransmitters such as dopamine and serotonin. SAMe facilitates glutathione usage and maintains acetylcholine levels, helping to preserve cognitive function while aging and possibly attenuating neurodegeneration. In an 8-week clinical study involving depressed individuals with HIV/AIDS, supplementation with up to 1,600 mg of SAM-e considerably improved disposition on multiple standardized assessments. The effects of treatment with SAM-e became evident in as little as one week.
Magnesium. Magnesium deficiency has been linked to anxiety disorders in several clinical studies. Several human trials have supported the link between magnesium deficiency and anxiety. When taken for one month in combination with a multivitamin, zinc and calcium, magnesium dramatically decreased symptoms of distress and anxiety compared to a placebo. Further, supplementation with magnesium and vitamin B6 effectively reduced premenstrual-related anxiety. In a placebo-controlled study, dietary supplementation with magnesium reduced generalized anxiety disorder (GAD). In community-based studies, a small reduction in mood disorders was seen in those with higher magnesium intakes.
Groundbreaking research has recently shed light on a new preparation, magnesium threonate, which may overcome a longstanding obstacle in magnesium supplementation – blood-brain barrier permeability. High magnesium levels in the brain have been linked with superior cognitive function. However, conventional magnesium supplements are not efficient in raising these levels because they do not penetrate the blood-brain barrier. Researchers at the Massachusetts Institute of Technology have shown that magnesium threonate effectively elevates magnesium levels inside the central nervous system. The scientists also discovered that magnesium threonate improves cognitive function significantly better than other forms of magnesium.
Selenium. Selenium has been shown to reduce anxiety. In double-blind randomized clinical trials, subjects given 100 mg of selenium daily for 5 weeks reported improved mood and less anxiety. The same treatment regimen also reduced post-partum depression. Selenium supplementation reduces anxiety in elderly hospitalized patients, cancer patients undergoing chemotherapy, and HIV patients receiving Highly Active Antiretroviral Therapy (HAART). The role of selenium in supporting positive mood is quite complex. Selenium is a critical component in a variety of important enzymes whose action can significantly impact overall health. For example, the enzymes that help synthesize thyroid hormones. In a selenium deficient state, thyroid hormone synthesis may deteriorate, which can lead to poor mood and many other negative conditions.
- Fatty Acids
Omega-3 fatty acids. The omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are necessary for proper brain function. The typical Western diet has an overly high ratio of inflammatory omega-6 fatty acids to anti-inflammatory omega-3 fatty acids. Omega-3 fatty acids have been shown to have a variety of health benefits, most recently being improved mood and reduced anxiety. In one double-blind, placebo-controlled and randomized clinical trial, medical students were given either 2.5g/day of omega-3 polyunsaturated fatty acids (PUFAs) or placebo capsules containing the fatty acid profile of a typical American diet. Compared to controls, those students receiving the omega-3 capsules showed a 20% reduction in anxiety. In a double-blind, placebo-controlled study, omega-3 fatty acid supplementation for 3 months reduced anxiety and anger in substance abusers. Reduced test anxiety and lower levels of the stress hormone cortisol have also been associated with omega-3 supplementation.
- Nutraceuticals and Herbs
Botanical herbs have been shown to manage many psychiatric disorders, including anxiety. Being that the quality, composition, conditions for growth & extraction processes of herbal products can vary greatly, care should be taken in choosing an herbal remedy. The following herbs either have anti-anxiety effects or target key molecular sites associated with neurotransmitters in the central nervous system:
Ginkgo biloba. Several double-blind placebo-controlled studies showed that Ginkgo biloba binds to and activates the GABA receptor, and like a benzodiazepine, reduces anxiety in patients with generalized anxiety disorders without side effects.
Valerian (Valeriana officiaonalis). This temperate herb has been used for medicinal purposes since the time of Hippocrates. Components of valerian root have been shown in laboratory studies to bind to GABA receptors, increase the release of GABA, and decrease its reuptake. Valerian root extracts have also been shown to activate glutamic acid decarboxylase, an enzyme involved in the synthesis of GABA. In recent clinical studies, psychiatric rating scales have shown that a daily dose of 400-900 mg of extracts from valerian root is as effective as diazepam at reducing anxiety.
Lemon balm (Melissa officinalis). Lemon balm is a member of the mint family, sometimes used as a culinary herb and flavoring agent. The plant also has several anxiolytic (anti-anxiety) actions. In some studies, extracts from lemon balm have been shown to suppress levels of stress hormones (glucocorticoids) while also promoting the growth of new neurons, a process called neurogenesis. Moreover, lemon balm contains compounds that strongly suppress the breakdown of GABA, which may prolong the anti-anxiety effects of the neurotransmitter. In a human clinical trial, it significantly suppressed anxiety when combined with valerian root, another anxiolytic herb.
Rhodiola. Rhodiola rosea is a known adaptogen, an herb that helps improve one’s resistance to stress. It has also shown promise in alleviating anxiety disorder. Ten subjects receiving a daily dose of Rhodiola rosea extract for 10 weeks demonstrated significant improvement in symptoms of anxiety. Another similar 10-week study found that a 340 mg daily dose of Rhodiola rosea extract significantly eased symptoms of generalized anxiety disorder. Some studies have found that compounds in Rhodiola rosea help ameliorate the anxiety associated with smoking cessation.
Ashwagandha (Withania somnifera). Ashwagandha, or Indian ginseng, has long been used by Ayurvedic practitioners as a rejuvenating tonic. The herb has anti-inflammatory, antitumor, anti-stress, antioxidant, immunomodulatory, and rejuvenating properties. Ashwagandha has also been shown to reduce anxiety in humans. In a clinical trial, patients with significant anxiety were divided into two groups, and for twelve weeks were provided either psychotherapy or treated with naturopathic treatment including ashwagandha. The ashwagandha treated group demonstrated a greater reduction in anxiety parameters.
GABA, a neurotransmitter made from the amino acid glutamate, can be taken in the form of a dietary supplement. GABA is the chief inhibiting, or calming neurotransmitter in the brain, functioning as a brake on the neural circuitry during stress. Low GABA levels are associated with restlessness, anxiety, insomnia and a poor mood. Clinical studies have shown that the use of GABA as a dietary supplement relieves stress, anxiety, and increases the production of alpha brain waves (associated with relaxation.
N-Acetyl Cysteine (NAC) shows promise for alleviating mood disorders through a variety of mechanisms. It acts as a precursor to glutathione, a potent cellular antioxidant that may help ease neuronal oxidative stress. Furthermore, in contributing to glutathione synthesis, NAC uses up excess glutamate stores. This might lessen the excitatory transmission triggered by glutamate.
Vitamin D. The impact of this hormone-like vitamin on mood disorders is complex. There are receptors for vitamin D throughout the brain, and data indicates that lower vitamin D signaling leads to increased anxious behavior. There is a considerable association between low vitamin D levels and depression, but the connection with anxiety is less clear. Nonetheless, maintaining a vitamin D level between 50 – 80 ng/ml is suggested for everyone to promote optimal health and protect against the ravages of aging.
Our bodies are truly elegant in their design. This is especially apparent with brain function. A common element of this design is the brain’s binary systems, wherein one chemical activates a process while its partner turns it off again. One example is glutamate and GABA, which together account for over 80 percent of brain activity. Glutamate accelerates brain activity (excitatory), while GABA puts the brakes on (inhibitory). Together, they keep the brain humming along at just the right pace—not too fast, not too slow. If you have developed anxiety, then the balance of these two chemicals has been thrown off. As a result, the brain’s activity level is turned up too high, at least in some areas. The balancing supplements for glutamate and GABA include but are not limited to the amino acids GABA, and L-theanine; the antioxidant NAC; vitamins B6 and D; the minerals magnesium and zinc; and omega-3 fatty acids.
For all health conditions, the nutraceuticals are individually tailored by the Health Renewal Doctor. The doctor will decide- based on your history, physical examination and blood tests what would be the best for you and your specific needs and/or deficiencies. It cannot be overemphasized that one must not self-medicate. Self-Medicating is done when a person takes prescription medication or nutraceuticals on their own without a doctor's supervision and/or consent. By not having a physical examination and blood testing done by a qualified and practising integrative medical practitioner, you could be not treating vital deficiencies or conditions such as elevated blood pressure, high sugar level, high stress levels (that can lead to adrenal burnout ) and high blood clotting factors that could lead to heart attacks and stroke. In addition, aggressive program of dietary supplementation should not be launched without the supervision of a qualified physician. Several of the nutrients suggested in this protocol may have adverse effects. There is no single supplement prescribed to clients as there is no magic bullet that can support all the essential nutrients that one's body needs. Today's food is not functional and we need to supplement in order to maintain optimal bodily functions and nutrition.
Make an appointment to consult with your Health Renewal Doctor who is an integrative doctor and he / she will assist you in determining your risk factors and how best to prevent any problems or conditions that you may be susceptible to. The importance of early management of any condition cannot be overstated. Once certain conditions set in and damage to organs occurs, complete recovery may be difficult to attain. Best results for prevention and longevity is early detection of a possible problem combined with conventional treatments, nutritional supplements and a healthy diet and lifestyle.
The diagnosis of an anxiety disorder can be difficult due to the overlapping symptoms it shares with depression. A person can move between anxiety and depression, but because many of the same mechanisms are involved in both disorders, treatment for the one usually helps with treatment of the other.
Treatment of anxiety disorders consists of a holistic approach. The diagnosis is usually made on clinical findings, based on the patient’s specific history & evaluation. In-depth blood screening will be done for all patients to identify underlying abnormalities within the body. A treatment protocol will consist of a combination of the following: possible medication, nutraceutical supplementation, hormone restoration, lifestyle changes, relaxation therapy, and psychotherapy such as behavioural therapy and cognitive-behavioural therapy.
The initial medical consultation at Health Renewal will be approximately 45 minutes. As this is a prolonged medical consultation, the initial consultation fee will be R 975 on arrival (for non loyalty programme members) you will have to complete an in depth questionnaire before the consultation so please arrive 20 minutes before the time. During the 45 minute consultation your Health Renewal doctor will obtain a FULL medical history from you to determine your personal risk. A physical examination will be done after which the Doctor will decide which blood tests need to be requested from your local pathology laboratory. If you have a medical aid, these should be able to be claimed as well.
Once your blood results are received, they will then be analyzed by your Health Renewal doctor who will begin working on a unique prescription plan for you with the compounding pharmacy. At your pre-scheduled second appointment 2 weeks later, the results and examination findings will be discussed with you. This will determine what abnormalities or deficiencies exist and you will be advised on your treatment options. These options may range from prescription medications, nutraceuticals, bio-identical hormonal creams / tablets or alternatively to having bio-identical implants / pellets inserted.
In office treatments such as carboxytherapy may also be recommended for certain conditions such as hair loss, erectile dysfunction ED, menopause or PMS. If you need to lose weight our Body Renewal Medical Weight loss program may be recommended. All these recommendations will be summarized on a sheet / print out which you can take home with you. The nutraceuticals offered at Health Renewal are of superior quality (Solgar) and are not rancid nor contain Hg (mercury ) or PCB'S (which is very important for Omega 3 Essential fatty acids EFA's). They are also free of gluten, preservatives, wheat, dairy, soy, yeast, sugar, artificial flavor, sweetener and colour. We have a great professional team made up of doctors, trained and registered nurses and therapists to support you at any time.
1. You are kindly requested to bring any supplements that you are currently taking, along to your consultation. The doctor can check the ingredients in take this into account when prescribing a treatment plan for you.
2. Also, if you have had any blood work done in the past 6 months, please bring the results along to the consultation. Should you not be in possession of the hard copies, please request these results from the lab you visited. Usually your ID number is sufficient.
Depending on the exact prescription given, you may be required to return to the doctor within 2 to 3 months’ time, in order to ensure optimum thyroid hormone levels are achieved. This will be determined by a repeat blood test and may be requested by your Health Renewal doctor.
You should ensure that you are current with your gynaecological visits/breast exams/mammograms (for female patients) and prostate exams (for male patients) as recommended by your GP/gynaecologist.
- The fee for the initial consultation and evaluation of 45 minutes is R975. A deposit of R400 is required up front in order to secure your consultation with the doctor. This advance payment goes towards your consultation fee. Proof of payment needs to be received one week in advance of appointment email. Please see banking and contact details below. This consultation fee may be claimed back from your medical aid depending on which kind of medical over you have.
- A second follow up consultation is essential in order for the doctor to assess your blood work and prescribe a personalised treatment plan for you. Another deposit of R400 will be required to secure the second consultation.
- All subsequent follow up consultations with the doctor will be charged at R650 for 30 minute consultations. This may be amended from time to time at the practice’s discretion.
- You may pay for your consultation by cash, credit card or EFT.
- BIHRT prescriptions must be paid for prior to ordering, as each patient’s prescription is unique to his/her own needs, and you will receive an invoice advising you of the cost.
- The patient is responsible for paying all consultation and prescription fees to Skin, Body and Health Renewal – regrettably we do not accept medical aid.
An added bonus is that not only improving your health and well being, any nutraceuticals purchased will go towards loyalty points at any Skin, Body and Health Renewal branches
After the two week follow up, the initial blood results will be discussed and patient specific nutraceuticals may be initiated. A second follow up another evaluation and blood test at 8 weeks is recommended to measure serum improvements in your Lipogram, homocysteine and other essential blood results. Follow up appointments should be very 6 months.
The importance of early management of any condition cannot be overstated. Once certain conditions set in and damage to organs occurs, complete recovery may be difficult to attain. Best results for prevention and longevity is early detection of a possible problem combined with conventional treatments , nutritional supplements and a healthy diet and lifestyle.
Some days you need some help staying motivated to live a healthy lifestyle. Our compilation of health and wellness quotes and sayings provide the inspiration or the laugh you need to keep making positive choices for your overall wellbeing.
Here are quotes from great thinkers to calm us, motivate and inspire us to exercise, eat right and live healthier lives:
- "Health and intellect are the two blessings of life" - Menander (ca. 342–291 BC) – Greek dramatist, the best-known representative of Athenian New Comedy
- "Beauty is whatever gives joy." ~ Edna St. Vincent Millay
- "Gratitude is a moment-to-moment celebration." ~ John-Roger
- "Life is really simple, but we insist on making it complicated." ~ Confucius
- "Wherever you go, ask for God’s Light to surround you, protect you and fill you. Place it ahead of you wherever you are going so that you will always be well received." ~ John-Roger
- "If I had my life to live over again, I would ask that not a thing be changed, but that my eyes be opened wider." ~ Jules Renard
- “Meditation is the ultimate mobile device; you can use it anywhere, anytime, unobtrusively.” ― Sharon Salzberg, Real Happiness: The Power of Meditation
- “No body is worth more than your body” ― Melody Carstairs
- “Restore your attention or bring it to a new level by dramatically slowing down whatever you're doing.” ― Sharon Salzberg, Real Happiness: The Power of Meditation
- "... Meditation is a tool to shake yourself awake. A way to discover what you love. A practice to return yourself to your body when the mind medleys threaten to usurp your sanity.” ― Geneen Roth, Women Food and God: An Unexpected Path to Almost Everything
- “One doesn't have to be religious to lead a moral life or attain wisdom.” ― Allan Lokos, Pocket Peace: Effective Practices for Enlightened Living
- “I believe that the community - in the fullest sense: a place and all its creatures - is the smallest unit of health and that to speak of the health of an isolated individual is a contradiction in terms." ― Wendell Berry, The Art of the Commonplace: The Agrarian Essays
- “I read once that you need two things to be happy: any two of health, money, and love. You can cover the absense of one with the other two... But now I realized this was unmitigated bulls##%# , because health and money did not compare with love at all.” ― Max Barry, Machine Man
- “Mindfulness isn't difficult, we just need to remember to do it.” ― Sharon Salzberg, Real Happiness: The Power of Meditation
The importance of early management of any condition cannot be overstated. Once certain conditions set in and damage to organs occurs, complete recovery may be difficult to attain. Best results for prevention and longevity is early detection of a possible problem combined with conventional treatments, nutritional supplements and a healthy diet and lifestyle.
- Control Your Breathing
- Severe anxiety symptoms are often linked to poor breathing habits. Many men and women with anxiety suffer from poor breathing habits that contribute to anxiety and many of the most upsetting symptoms. Take more controlled, slower, shallower breaths, using the following technique:
- Breathe in slowly and gently through your nose for about 5 to 7 seconds.
- Hold for about three or four seconds.
- Breathe out slowly and gently through pursed lips like you're whistling for about 7 to 9 seconds.
- Repeat this exercise ten to twenty times. This method of breathing will ensure that you're not hyperventilating (a common problem of those with anxiety) and will help to regain the CO2 balance in your body that creates many of the worst anxiety symptoms.
- Talk to Someone Friendly
- Effective anxiety reduction is often about distraction, since your mind can be your worst enemy when you have severe anxiety symptoms. A very effective technique is to talk to someone you like and trust, especially on the phone. Don't be shy about your anxiety – tell them you feel anxious and explain what you're feeling. Talking to nice people keeps your mind off of your symptoms, and the supportive nature of friends and family gives you that added boost of confidence. If you're suffering from a panic attack, it also helps you feel more confident that if something was wrong, you'd have someone that can watch over you.
- Try Some Aerobic exercise
- During periods of anxiety your body is filled with adrenaline. Putting that adrenaline towards aerobic activity can be a great way to improve your anxiety. That's because exercise has numerous advantages for controlling your anxiety symptoms:
- Exercise burns away stress hormones that create anxiety symptoms.
- Exercise tires your muscles, reducing excess energy and tension.
- Exercise releases endorphins, which improve overall mood.
- Exercise forces healthier breathing.
- Exercise is a healthy distraction.
- Aerobic activity, like light jogging or even fast walking, can be extremely effective at reducing the severity of your anxiety symptoms, as well as your anxiety itself.
- Find What Relaxes You
- There are already things in your life that relax you. Don't avoid them and try to fight it out. Instead, do the activities as fast as possible. For example, if you find that a warm bath is relaxing, don't wait to take the bath. Jump in the bath, light some candles, add a few nice scents, and jump inside. Whether it's a bath, a shower, skipping stones at a park, getting a massage – if it works, do it right away, rather than let yourself become overwhelmed by your anxiety.
- Learn How to Trick Your Anxious Thinking
- Anxiety doesn't come out of the blue. When you have anxiety attacks, it's often because your mind has a tendency to spiral into negative thoughts – often without your control. Sometimes you can control this anxiety by keeping these thoughts at bay, and learning to dismiss triggers that cause you anxiety. For many, this is easier said than done. But there are many different strategies you can try that may be effective. These include:
- 1. A Question Checklist – When you feel severe anxiety, have a checklist on hand of questions to ask yourself about that anxiety experience. The longer the checklist, the more you'll find that your thoughts become more realistic. Questions that you can use include:
- Is there a reason to believe something is wrong?
- What evidence is there that something is wrong?
- Is there a chance I'm blowing this out of proportion?
- 2. Affirmations – Affirmations are not for everyone, but those that do use them find them to be very beneficial. Affirmations are things that you say to yourself to make yourself feel better. These include:
- "I’m okay. This is just anxiety and I will get over it."
- "I have a great life and I'm looking forward to tomorrow."
- "My anxiety won't control me."
- Listen to Good Mood Music
- Every little thing matters. That's why even if it sounds like it won't make a tremendous difference, listening to your favorite music can have a powerful effect on your anxiety. They key is to not just choose songs you like, however. The key is also to make sure you're listening to music that represents the way you want to feel. Happy or relaxing music, not just any music.
- The reality is that music does affect emotions. So while many people find it soothing to listen to angry music when you're angry or sad music when you're sad, the truth is that this type of music will only help you get in touch with those negative emotions. They won't help you feel better. When you're trying to stop anxiety now, you should listen to music that will help you feel the way you want to feel.
- Make Love: It's not a myth. Sexual intercourse can be incredibly calming. It is a distracting physical activity that releases endorphins and helps you feel more relaxed and less tense. If you have someone special in your life that understands that you're suffering from anxiety and is willing to share in some lovemaking in order to help you experience some relief from that anxiety, the two of you should come to some type of understanding that allows you to release some sexual energy, and possibly improve your relationship in the process.
- Living in Today
- Finally, simply learning to live for today can impact your anxiety. One of the most important things that psychologists and counselors teach those with anxiety is: "Okay, you're anxious. So what?"
- Those with anxiety often start to focus too much on how they feel and their worries about the future. Each day becomes trying to live with anxiety instead of trying to live in general. Learning to embrace the idea that you have anxiety and trying to live a great and exciting life anyway is important.