Tips To Reduce Stress and Anxiety, PART TWO

(audio transcript below)

Welcome to AIM For Health: Root Cause Conversations with Dr. James Biddle. All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition.

Hello everybody. I’m Dr. James Robert Biddle at Asheville Integrative Medicine. Today’s the 9th of July, 2020…and, what are we going to talk about today, Joy?

>>    So we have had a lot of great feedback from people who listened to a podcast we did recently on stress and the mind-body connection and stress management, and people want to know even more. So today we’re going to do a follow-up and talk about some things that we didn’t go over the first time in regards to stress… going over things pertaining to supplements, breathing, and other things we can do to help reduce our stress.

Yeah. Last time we talked mostly about behavioral things like eating, exercise, resting, grounding..

>>     Meditating….

Yeah.  All right. Well, number one on my hit parade is always magnesium.

>>   Yes. Supplements. 

Yes, supplements we’re going to talk about, and the number one supplement for me is magnesium, and funny (interesting)….when we get to diabetes, it’s magnesium (we need), heart disease….it’s magnesium, depression….it’s magnesium. Why? Because magnesium is our most important nutritional mineral. It runs over 400 known enzymes in our body.

>>   That’s incredible.

And two thirds of Americans are deficient in it.

>>    Why are we deficient in magnesium? 

Because we don’t get it in our diet enough. You get magnesium from eating a real food, not processed food, especially your vegetables, and Americans just don’t eat their vegetables. Or, they’re over-cooked or over-processed, and then every time you eat sugar, you waste magnesium.

>>    Right. Sugar, alcohol…there’s other things we’re doing that’s kind of sabotaging our magnesium supply. 

Exactly. So our original native diets had huge amounts of magnesium and potassium in them. And now instead we get actually more calcium and sodium in our diets and less magnesium and potassium. So we’re always, in our practice, trying to increase our magnesium and potassium intake.

>>    What are some foods that have magnesium in them? 

Well, greens! Greens have chlorophyll, which is interestingly almost identical to our hemoglobin except in the center of the chlorophyll, rather than having an iron, which makes our blood red, it has the magnesium, which makes the plant screen.

>>   Hmm! Fascinating.

Yes. And also Vulcans, if you have green blood.

>>   Hahaha! Live long and prosper.

Yeah. It’s shown that you’ve got to get about 300 milligrams a day of magnesium to do things like stabilize your blood sugar and control your blood pressure and make your neurotransmitters to help with anxiety and depression.  The downside to magnesium is if you take too much of it, you’ll get loose stools. Magnesium moves your bowels. And here’s an interesting paradox. The more deficient you are in magnesium, the less you’re going to tolerate before you get loose stools, because your ability to absorb magnesium is indeed a magnesium dependent enzyme in itself in your small intestine. So if you’re very deficient in magnesium, even small doses, it will give you the runs….which means if you get the runs with just a hundred milligrams of magnesium, you know you’re very, very deficient. And the way to get around that is to get a powdered magnesium and put it into your drinking water bottle and sip small amounts throughout the day. So you don’t get a big load all at once. You can absorb it easier and then gradually increase it.

Otherwise you can do topical magnesium creams, which I’m not real wild about because they tend to irritate the skin, and I’m not certain they actually work real well. I mean, they work for relieving muscle soreness locally, but as far as raising your body level….? Or we can give the intramuscular shots or IV magnesium, but you know, that’s inconvenient and expensive.

>>    Right! So if you’re not sure if you’re magnesium deficient and you want to start, but you also don’t want to be running to the bathroom. Maybe start that on a weekend when you’re not at work,

Just start low and work up. Start with a hundred milligrams a day, then a hundred milligrams twice a day, and then 200 milligrams in the morning and a hundred in the evening. And then if you can get to 200 milligrams twice a day, that’s a good dose for almost everybody. Now, the other time you should not take magnesium is if you have kidney failure.

>>   Why is that?

Because we get rid of extra magnesium through our kidneys and when your kidneys get down to about 30% functioning or less, then you start to retain magnesium and potassium. You have to watch your intake on those, but if you have that issue, you should know it.

>>   Yes. Most likely.

Most of us have good kidneys. So that’s the fundamental nutrient. Otherwise we get into a lot of kind of fun nutrients.

>>   Fun nutrients?!

Yeah, which is your favorite?

>> I have to say my favorite fun nutrient for stress relief is actually the Kava Kava, which is next on our list.

What do you know about kava kava?

>>   I know that you have to be careful with the kava, because you want to make sure it is produced from the root of the plant so that it does not become liver toxic as opposed to the leaves and the stems.


>>   So I get my kava kava from here, cause that’s something we pay attention to with the supplement store. And I know that it can be great. It’s kind of fast acting. So if you’re having some anxiety, or maybe you really have, the (mental) hamster will go on before bed and you can’t stop thinking all those thoughts, that a little dropper of that will help relax me.

Good. Yes. All that’s true. And the way kava works…it’s the one natural thing I know of that hits the benzodiazepine receptors. So it’s basically nature’s valium because it hits those same receptors. It’s used in Polynesia in their rituals. Historically I understand, I’ve never visited to research this myself, they ferment big vats of it and get a relaxingly into a trance with it.

>>   And it’s not habit forming.

It’s not habit forming. No. You’re not going to get hooked on it. I find that the capsules don’t work very well, that you really want a liquid. And you do not want an alcohol based liquid because that will rip your mouth up. It’s way too strong and harsh. What you want is a glycerin based liquid.

>>   Yes. And I can say from experience, the glycerin based one we have here is one that I actually enjoy the taste of.

I enjoy the taste. And like you said, it works really quickly. I can put it on my tongue. It is nice for going to bed, it’s nice for in the middle of the night if you wake up and you’re, like you said, your hamster wheel or your mind starts worrying about things, then it can calm that down. But it won’t interfere with driving or meetings. You can take it before meetings and other stressful family situations.

>>   Or even with melatonin, if it’s your bedtime.

Yes, even with melatonin. It mixes well with everything, you just need to get a good company so they don’t use the stems and the leaves because they have liver toxic alkaloids, you can only use the root. So that’s kava. The next one we can talk about is CBD oil. CBD oil is all over the place. People are hearing a lot about it since it was legalized last year to be sold across state lines. And it’s the non psychoactive component of hemp, which is related to the marijuana plant. The CBD, I gotta say, it works miracles for some people and for other people, it’s like a placebo, it has almost no effect. And I’m not sure exactly why that is, but it’s really worth a try.

It’s used for anxiety. It’s used for pain and it’s used for insomnia. And if you have either of those, it’s really worth giving it a good try. The cost has come down to about a fourth of what it was about two years ago. You can now get a good 20 to 30 milligrams in a dosage and get a bottle that will last you two months for $30. Whereas it used to be a hundred dollars for 10 milligrams for a month.

>>    Right. Also non habit forming. And there’s other things that are good about it too.

Now, if you are in a profession that you get drug tested randomly…it is possible that you can get a positive test on your THC or marijuana assay. So you do have to be careful about that. But otherwise it’s worth a good try. Next we can talk about GABA, which is Gamma Amino Butyric Acid, and that’s an actual neurotransmitter. Supposedly GABA does not cross the blood brain barrier. Did you know that?

>>   I did not know that!

Yeh, supposedly if you are a perfectly healthy person with an intact blood-brain barrier, GABA won’t get from your intestines into your brain. I think none of my patients must be perfectly healthy with an intact blood brain barrier because it seems to work for people anyway. So GABA is another one of those that’s good if you have your mind racing around round circles with excessive thoughts and worries. It kind of slows down how fast your neurons are all firing.

>>    And just to make sure that we’re explaining everything and people are able to keep up well, what is a neurotransmitter? How does that work? 

Neurotransmitters are how one neuron in your head talks to the next neuron and sends signals. So there’s activating neurotransmitters that are really the same stuff that our adrenal glands put out, the epinephrin in the norepinephrine are also neurotransmitters, and then there’s feel good neurotransmitters like serotonin and dopamine. And then GABA is the ultimate calming neurotransmitter. It calms everything down. And so thats very good. There’s also your basic nutrients, for example, that are involved in the neurotransmitter production, like magnesium.

One of the reasons the magnesium is so important is because when you are deficient in magnesium you can’t make your neurotransmitters. So really, if we lived in a world where our medical profession was not completely controlled by Big Pharma, what makes them money, every time your doctor prescribed an antidepressant or an anti-anxiety medication, they would also prescribe you magnesium to help it work.

>>   To help it work!

But the only reason they don’t is because magnesium cannot be patented.

>>   There’s no money in it.

There’s no money in it for anybody. And so doctors aren’t trained to do that, which is a darn shame.

>>   Yes, it is.

Or you could use harsher words.  So the next would be tryptophan…talking about that. Tryptophan is the direct precursor for serotonin, which is one of our feel good neurotransmitters. And then tyrosine is the direct precursor for dopamine, which is our kind of other feel good neurotransmitters, especially people who have had history of addiction problems. They’re usually low in dopamine. For example, even when developers, software developers are looking at things like Facebook algorithms and TikTok and gaming, they actually hooked people up to brainwave machines and other devices, and they measure your responses, including your dopamine response. Because that’s….the better you can get people to feel that dopamine rush, the more addictive their apps are going to be for you to keep coming back to. Isn’t that wild!?

>>   It’s a little too wild for me.

Yeah.  So, tryptophan with the serotonin tends to be very calming and helps you to go to sleep. So most people take tryptophan at bedtime. It comes in 500 milligrams…usually I take one, two, or even up to three of them at a time. But you’ve got to be careful because you can’t take tryptophan if you’re taking a prescription antidepressant like SSRI’s, the selective serotonin re-uptake inhibitors, like Prozac and such.

>>   Why is that?

Because you can get a kind of overdose in your brain of tryptophan all built up at once…of serotonin…and that’s called serotonin syndrome, and that can be uncomfortable. I just pushed my dosage up once to see what this was like. It took me 6,000 milligrams of a tryptophan to get to serotonin syndrome.  And it felt like I had the heebie-jeebies. I couldn’t go to sleep. I laid there kind of a with my arms and feet wanting to move….that’s called akathisia. You just kinda lay there feeling like you’re having the heebie-jeebies.

Now when you’re on a prescription medication and then you take that much tryptophan, you can actually get into a very serious, dangerous situation where your pulse and blood pressure yet control. So you gotta watch those combinations. But the tyrosine is much safer and that’s more activating. So usually take that in the morning. Both are best on an empty stomach because amino acids kind of disappear into food. They’re both amino acids. The tyrosine also helps your thyroid because a molecule of thyroid hormone is basically four tyrosine’s with four iodine’s on it. And then you activate that from T4 into T3, by knocking off one of the iodine’s.

So when you take tyrosine in the morning, not only do you help your energy by helping your dopamine and your attitude, but you also help your energy by helping your thyroid functioning.

>>   That is really good to know.

That’s really good to know. And so that’s again about 500, a thousand, maybe 1500 milligrams in the morning. Now we can actually measure neurotransmitters. We can measure your dopamine, your serotonin, your epinephrine, and your norepinephrine and your GABA, and we measure that in your urine. And realistically, what we’re measuring is more what you’re making in your gut than your brain. You know, that guts often called the second brain, right? And you have your gut feelings, but from biochemical and genetic point of view, your patterns are going to be the same. So what’s coming out your urine is going to tell us what your body is needing, and what you have too much of and not enough of. So that can then guide us in what supplements to give you to calm down your anxiety or to help lessen your depression and even what prescription medications you should take. But in order to get accurate neurotransmitter testing in your urine, you have to be off of prescription medications at the time you can’t be taking an SSRI or something like that.

>>    For how long would you have to be off of that? If anyone’s interested in doing the neurotransmitter testing?

I’ve been thinking several weeks. So you can kind of reestablish your balance. Ideally more than six weeks because you’re going to have a dampening effect that’s going to take time to recover from. So we’re still seeing the effects of that. All right, the next one I talk about is L-Theanine. And L-Theanine is an amino acid that’s in green tea. So both green tea and coffee have caffeine.

>>   Yes they do.

But coffee kind of jacks you up and makes you hyper and then dumps you on your butt when you crash, and green tea kind of lifts you up, but it lets you down really easy and you don’t get as anxious, and you stay calmer on green tea. And L-Theanine is a lot of the reason why. Because it has this thing that calms down your brain and they take L-Theanine out of that and put it into capsules. So it’s usually a hundred milligrams in a capsule, sometimes 200 milligrams. And L-Theanine has been shown to take your brainwaves into the brainwaves of meditation, which are the calmer brainwaves.

>>    So even though green tea is giving you caffeine, which will give you that boost, and sometimes that little energy rush, it actually can have a calming effect too.

Exactly. Because it’s balanced out.

>>   Now I’m about to say something that some would consider heresy. Does that mean that green tea is better for us than coffee? 

Well, since my wife is French and Dutch, I would never go quite that far, because we love our coffee. But you know, I’ve been studying coffee for a long time. I keep a file folder now in the computer on studies on coffee. And I started off really kind of prejudice against coffee, because I watched my mother get fibrocystic breast disease from drinking coffee, and watched her get much better when she stopped it. And I’ve watched many, many men get prostate issues from coffee. Because just like it makes the breast tissue kind of get fibrocystic, it makes the prostate tissue get fibrocystic and enlarged, because BPH symptoms four guys. But on the other hand, there’s many, many studies showing that coffee has lots of positive health effects. It’s one of our major antioxidant foods that we eat.  Not because it’s such a great antioxidant, because we drink so much of it, so there’s many good things about coffee.

>>   I am glad to hear that.

Yeah, but green tea will definitely keep you calmer than coffee. You’ve gotta admit that, right?!

>>   Okay. That’s good to know!

And I want to get back to making the neurotransmitters, besides needing magnesium as a cofactor, you have to have B6, but when you take B6 as a supplement, there’s impurities in it that can actually cause neuropathy. So when you take B6, you should always take the activated B6 called pyridoxal-5 phosphate or P5P. You should never take plain B6, and P5P is about two to three times more potent. So 50 to a 100 milligrams of P5P is equivalent to 200, 300 milligrams of regular B6. So you don’t need a whole lot of it, but you do need a little bit of it. And we’ve actually reformulated our multivitamin to make sure that we only have the activated B6 in there.

>>   Right. And we do have just P5P in the supplement stores if anyone’s interested. 

Exactly. And then we get into some herbal things. Ans a lot of these, interestingly, are also about the adrenal glands…about calming and supporting the adrenal glands. And you would think that, Oh, if I’m going to support my adrenal glands, I’ll be making more adrenal hormones, and that’ll make me more anxious, but that’s not the way it goes necessarily. That’s when your nervous system is tweaking your adrenal glands and giving it that fight or flight response, but healthy adrenal glands actually are part of us staying calm. So these herbs include Holy Basil, which is also called Tulsi, and Milky Oats. Also, shizandra and ashwagandha. And I’m not an herbalist, so you can talk to your favorite herbalist about how they think all these work biochemically, but I know that they all support the adrenal glands, and by supporting the adrenal glands we actually seem to help people call them down.

The next one also with the adrenal glands is called Phosphatidylserine. It’s not an herb, it’s a phospholipid. It is part of our neurons…the cell membrane of our nerves has this in it and it makes those cell membranes calmer, when it builds up in them, and also calms down the adrenal glands. And, the adrenal glands are like one big nerve ending that’s designed to release those now as hormones into the bloodstream, rather than just talking to another nerve ending. So the phosphatidylserine helps both calm your brain down and your adrenal glands down. So that’s usually a hundred milligrams taking one, two, maybe three of them at bedtime…is usually when we give that, so that also helps people sleep.

>>    Question about the adrenal glands and these options. If you know, or even if you don’t know or suspect that you might have adrenal fatigue, because we know that that is a real thing,  then is that something that’s okay…to try these herbs? 

Yeah, absolutely. They’re supportive. And of course, why do you have adrenal fatigue? It’s because of decades of unmanaged stress of one type or another, whether that’s emotional stress, physiological stress, usually both. So managing the stress. So let’s talk more about managing stress. We talked a lot last time, but we didn’t talk so much about breathing and what’s cool about breathing is that when you don’t think about it, you still breathe.

>>    Right. Autonomic function!

Autonomic function. But when you think about it, you can change your breath. So that makes it a somatic function. The two main parts of our nervous system, the autonomic and the somatic. So it’s one of those places that links the somatic to the autonomic or the voluntary to the involuntary, which means it’s a way that we can voluntarily affect our involuntary nervous system. So by influencing our breathing, we can calm down our fight or flight response. And basically what we got to do is we got to activate our parasympathetic, which is mostly operated through our vagus nerve.

>>   And where’s the vagus nerve?

Well, the vagus nerve is the 10th cranial nerve. So it comes out of our brainstem in our upper neck, lower brain. And it travels down our neck and innervates all of our intestinal organs, including our esophagus, our heart, our blood vessels, our entire intestines, our liver, pancreas, spleen, everything in there. And basically when you are in fear or anger, some sort of a fight or flight, it shuts the blood down to all the digestive type things that you don’t need right now to survive the tiger, and increases the stimulation to the thing that you do need like tightening your blood vessels and making your heart beat faster and things like that.

>>   Getting ready to run.

Right. So when you’re chronically in that state you’re going to have poor digestion and low stomach acid and all the things we talked about before. So in order to heal and especially calm down your adrenal glands, you want to keep activating the parasympathetic relaxation response of your vagus nerve, and one of the ways you can do that is by breathing. And my favorite breath is a deep rhythmic breath called the ocean wave breath. And when you sit and look at the ocean with its waves going in and out, you’ll notice that it never stops.

>>    No it’s continuous.

It’s continuous. So the wave comes in, the wave goes out, but there’s not a place where it is frozen, but when we get into a fight or flight response, our breathing freezes. So to do this breath, what you want to do is…you don’t want to put efforting into it, but you want to just start off by observing how you’re currently breathing, and then just let your breath go gently in and out, but as soon as you get to the top, then it starts going out again, like the wave. And as soon as you get to the bottom, it starts to come in again, like the wave, but you don’t really push where it is at the top and the bottom. You just kind of let it be, but make sure it doesn’t freeze. And that’s the simplest, I think most easy way to get into a relaxing breath mode.

>>    And with the breaths, do we want to be looking at short breaths, deep breaths? Could you talk a little bit about that? 

Well you want deeper, but you want to do that very gently without stressing yourself. If you work on it, then you’re actually not going into the relaxation, you’re going into the excitatory phases. You can get a lot more sophisticated, where if your exhales are slightly longer than your inhales, that’s relaxing, but again, not if you’re working at it. So you’ve got to find that balance. So I think that for people who are just getting into this, simply observing it and doing the ocean wave where you’re not trying too hard to control it, except you’re just making sure you’re not frozen at any point. And you just keep it moving in and out.

>>    And does positioning matter. Is it ideal to be sitting up, laying down, standing up?

You can do it in all those. I don’t think the position matters that much. No. Whatever’s comfortable. And the last thing we’re going to talk about is neurofeedback. And we’re big fans of EEG biofeedback. This is where people use machines to actually give you a look at what your brainwaves are doing and identify where you’re too jacked up and where you’re too ramped down, or suppressed. And then they can have a feedback technology that helps to even all of that out. And I don’t know this intimately, but I know there’s basically two types of feedback technology. One is when you’re an active participant, and the other is when you’re a passive participant and the machine does it with your brain. And the active participant is usually… you’re watching a video, and when your brain’s not doing what they want it to the video kind of fades out and isn’t as clear. And then when your brain does what they want it to, then the video is more clear. So it’s work, but it’s not work that the way you think of work.]

>>    Right. It sounds like it’s kind of refocusing the brain a bit. Training it to refocus!

Training it to refocus and to wake up the parts that are damped down and such. So there’s three places in Asheville that can do this. And it usually looks like doing a half hour to an hour at a time, usually going once a week, usually starting with 10 to 20 visits, and then maybe backing off to maintenance of a once a month to every six weeks after. So the first one is Dr. Yonce at Asheville Brain Training. The next is Dr. Michael Trayford, and Denise Trayford, and Diana Tyler at Apex Brain Center. And then Sean Jarman is a licensed professional counselor at Jumpstart Counseling and Neurofeedback. So we’ve had good reports on all of their interactions with clients. And if you’re not able to get your own nervous system calm down enough, then getting some help like that can really change your life.

>>    It is always good to have those options.

That’s right. So you have the options of these supplements…. magnesium, kava, GABA, CBD oil, L-theanine, tryptophan, tyrosine, P5P. Oh, we didn’t talk about a inositol.

>>  Oh no, we missed that one.

Yeah. And inositol is an alcohol sugar, kind of like a B vitamin. It’s also a component of our  nerve membranes, the membranes of our neurons. You can’t overdose on that. It tastes wonderful. It’s a white powder that tastes like sugar. It is very calming. I get good effects with it. I take it myself, I put it into my smoothies. And interestingly it’s been shown through regular medical studies to help with obsessive-compulsive disorder, and to help with polycystic ovarian syndrome. In PCOS, the ovaries aren’t getting the signal from the pituitary, the hormonal signals of LH, it doesn’t receive it very well, but by softening those cell membranes, they work better and receive that signal better so that the PCOS symptoms lessen dramatically.

>>   That’s a great to know.

It’s just great to know. That’s also very calming. And then the phosphatidylserine and the adrenal herbs. Alright, those are things that you can do with supplements, and a few other behavioral things to lessen anxiety and stress. Any parting thoughts?

>>    Yes, of course! If you have questions about what’s going to be the best avenue for you, how to put this all together, if you want a little more structured advice, give me a call, especially if you’re interested in establishing care, because this is all part of the care that we do here and that we are happy to help people with every day.

And if you have other questions for ask Dr. Jim Bob, then just to email them to and we’ll talk to you next week.

>>    All right. Take care. 



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