19 peter bongiorno serotonin anxiety happiness digestion and …€¦ · • serotonin’s effects...

Dr. Peter Bongiorno - Serotonin and Anxiety, Happiness, Digestion and our Hormones www.theAnxietySummit.com May 6-20, 2015

© 2015 Trudy Scott All Rights Reserved of 32

Serotonin and Anxiety, Happiness, Digestion and our Hormones

• What is serotonin and why is it often considered the molecule of happiness • The role of serotonin when it comes to anxiety? • How serotonin was first discovered and the 5-HT1A receptor/oxytocin

connection • Serotonin’s strong relationship to the digestive tract • The connection between inflammation and serotonin • How to naturopathically support serotonin and the overall neurotransmitter

system for optimal mood support: 5-HTP, L-tryptophan and its vitamin co-factors

• Serotonin’s effects on our hormones, other neurotransmitters and whole body

Trudy Scott: Welcome to Season 3 of The Anxiety Summit. I'm Trudy Scott

your host. I'm a food mood expert, certified nutritionist, and author of The Antianxiety Food Solution. Today our topic is: "Serotonin and Anxiety, Happiness, Digestion, and our Hormones." And we have Dr. Peter Bongiorno as our expert today. A very big welcome Dr. Bongiorno.

Dr. Peter Bongiorno: Oh thank you so much. It's wonderful to be here Trudy. And

thank you for all the amazing work and information you're bringing to people.

Trudy Scott: Well it's really good to have you here and I'm excited for this topic.

I'm very, very interested in the neurotransmitters. And when I came across you and your wonderful books I thought this is



someone that I really want on The Anxiety Summit. I'm really pleased to get to know you and to learn from you and to share your great wisdom with our guests today.

Dr. Peter Bongiorno: Well thank you so much. And I'm learning a lot from you every

day. So thank you. Trudy Scott: Well that's good. We're all learning which is great. So let me read

your bio and then we will go right into our great topic today. Dr. Peter Bongiorno is co-medical director of InnerSource Natural Health and Acupuncture, a thriving practice with two clinics in New York (New York City and Long Island). He specializes in mood disorder and depression.

Dr. Bongiorno teaches an integrative medicine elective at the Mount Sinai School of Medicine and also lectures at the Natural Gourmet Institute in New York City. He is an expert blogger for Psychology Today, and has appeared multiple times on national FOX News programs. He is current President of the NY Association of Naturopathic Physicians and, was chosen naturopathic physician of the year in New York State in 2008.

Dr. Bongiorno is a major contributor to the Textbook of Natural Medicine and authored the 2010 textbook for physicians Healing Depression: Integrated Naturopathic and Conventional Therapies for Depression. He authored How Come They’re Happy and I’m Not - The Complete Natural Program for Healing Depression for Good, and Holistic Therapies for Anxiety and Depression recently released by WW Norton. Peter loves running outside, playing the drums, making breakfast, and enjoying life with his daughter Sophia and fellow naturopathic doctor Pina LoGiudice. I hope I got that name correct.

Dr. Peter Bongiorno: So LoGuidice – a very Sicilian name just like mine. Trudy Scott: Oh – Dr. Peter Bongiorno: It's really Sicilian. [laughter] Trudy Scott: I really messed that one up. Sorry about that. [laughter] You can

find Peter – Dr. Bongiorno – on Facebook (@drbongiorno) and learn more about him on Facebook or through InnerSourceHealth.com and drpeterbongiorno.com



So as I said your books really caught my eye. And I read your recent book Holistic Therapies for Anxiety and Depression from cover to cover. And it's fabulous, so congratulations on that one certainly and your other one. But this new release is a great one. And I know you say in the book that it's designed for the busy mental health professional abut I find it really good from a nutritional point of view as a nutritionist.

I think it's great for nutrition professionals and other healing professionals who want to learn more about holistic mental health approaches. And I know earlier you'd said to me this would also be a good book for the consumer who wants to take a deeper dive into this.

Dr. Peter Bongiorno: Yeah absolutely. It's definitely written in a friendly enough language which we worked on specifically to make sure it was a little more reachable. Some of the big words are explained. And some of the more overarching concepts are also explained too to make sure that the reader has a sense of what's going on. Yeah and so far I've gotten good feedback from a number of different practitioners.

And it is I think very good for a nutritionist because food, diet, our digestive system is really the basis of creating health in our body including good mood and lowering anxiety. So it definitely lends itself to that.

Trudy Scott: Right. And something that I really appreciated that you say is this comment about insanity: doing the same thing over and over again and expecting different results. Can you talk a little bit about that before we start talking about serotonin?

Dr. Peter Bongiorno: Oh sure. Well you know obviously that's not a concept I came up

with right? But it does resonate I think especially when working with mood disorders and anxiety and depression as well. You know I think in modern medicine we tend to focus on one thing and we tend to kind of sort of work it to death, and almost to the point where we believe those things we're doing are helpful.

I remember when I was writing about depression, when I first started working on that a number of years ago.

Studies came out that really showed that antidepressants weren't

working any better than placebo in most people. And even though that came out in 2008 in the New England Journal of Medicine and 2010 and the Journal of the American Medical Association we're



still doing the same thing. And we're still treating people the same way with depression. So it's just what we do I think in modern medicine and modern bio medicine.

You know where I went to school was a naturopathic medical school. And that kind of holistic thinking is very, very different. It looks at things from all angles. And what we realize is that even though somebody presents with something like anxiety there are multiple factors involved in why someone has anxiety and how you're going to work with them successfully to move through that is going to be very different for each person.

Trudy Scott: Great point. And that's a really good lead in to our topic because

we're talking specifically about serotonin here and this is obviously a factor or a possible factor in anxiety or depression. It may be one of many factors and you may have anxiety and depression and not have issues with low serotonin. So I think that's a really important distinction to make. It's not the only answer and it may not be a factor. And there are all these other angles that you mentioned that we need to look at which is so important.

Dr. Peter Bongiorno: Yeah there's no question about it. Serotonin is a major player. But

one of the reasons why it might be a major player is because it's the one that was focused on. You know there's an old joke that there's a fellow who he walks out of the bar. He's very drunk. It's nighttime. And he went to the parking lot to find his parked car. And he lost his keys. So now he's looking for the keys in the parking lot. And there was one light post.

And he's looking for the keys in the light post area whereas there's a whole rest of the parking lot that's still very dark. And a police officer comes up to him and say, "Hey man, you know, what are you doing?" And he says, "Oh I'm looking for my keys." He says, "Well why are you looking here?" And his answer to the officer was, "Well because the light's better here."

Trudy Scott: [laughter] Dr. Peter Bongiorno: And I think this is what we're doing with serotonin and

neurotransmitters and modern medicine. You know the research came out about serotonin and it's strong. And there's a lot of it and we certainly need to look at it. But it's one piece of a very larger picture. And I think if we only focus on serotonin you know we'll be missing the rest of the body and all the other interactions that go on.



Trudy Scott: Absolutely. And now we're seeing so much more research coming out about inflammation and the gut and food and so many other factors. And the interesting thing is a lot of those actually tie in closely with serotonin and we'll talk about some of those a little bit later.

Dr. Peter Bongiorno: Sure. Trudy Scott: It's just interesting to see how things are. We're starting to fill in

the gaps where we might've had gaps before. So let's start with what is serotonin just for someone who may not know what that is?

Dr. Peter Bongiorno: Sure. Well it's a molecule and it's produced mostly in the digestive

tract. It's also produced in the brain and in some other areas. But about 90-95 percent of the body serotonin is actually made in the digestive tracts in the cells called enterochromaffin cells. It's also produced in the brain. There's an area in the back of the brain – in the primitive part of the brain – where a lot of the serotonin is produced. And it affects different brain areas.

Candace Pert would call it one of the molecules of emotions. It's

one of those molecules that will affect how we feel along with other neurotransmitters. So serotonin is a neurotransmitter. Dopamine is a neurotransmitter. Epinephrine or epinephrine and norepinephrine are also neurotransmitters. And they all have different effects on how we feel.

And the neurotransmitter is kind of special in that typically that

kind of molecule gets let out in between nerve cells and then it gets recycled back. And that's one of the reasons why it's considered a neurotransmitter versus other molecules that are called different things like neuropeptides for example.

Trudy Scott: Okay great. And so can you just repeat the name of the cells in the

digestive tract?– Dr. Peter Bongiorno: Oh sure they're called enterochromaffin cells. Trudy Scott: Right. Dr. Peter Bongiorno: Anytime you see the letters that spell "entero" it usually refers to

the digestive tract. In fact one of the earlier names for serotonin was enteromine because some of the biologists that first found it in the digestive tract. So entero usually refers to intestines.

Trudy Scott: So it's called enterofim – F-I-M?



Dr. Peter Bongiorno: Enteromine. Trudy Scott: Mine – enteromine. Dr. Peter Bongiorno: Enteromine yeah. Trudy Scott: Okay great. Dr. Peter Bongiorno: [laughter] Trudy Scott: Good to know. I love learning about the history. That's great. Dr. Peter Bongiorno: Yeah well it does have a really interesting history actually –

serotonin. You know it's really fascinating because in the late 1800s – remember that fellow Pavlov – the fellow with the dogs and the saliva response?

Trudy Scott: Yes. Dr. Peter Bongiorno: Well he actually had this side interest. He published a small paper

about how he was looking at clams. He was thinking about the clams and how clams stay shut all the time.

Trudy Scott: Mm-hmm. Dr. Peter Bongiorno: And they have this very large muscle to do it. And he was

wondering how do those little clams keep all that energy to hold that shell closed? And he couldn't quite figure it out. And then in the '20s there was a German fellow named Loewi – Otto Loewi. And he did some studies with the heart where he took some frogs' hearts out and he studied them. And what he realized is that if you took a racing frog heart – the fluid that was around it – and you dripped it on a frog heart that was going slow it would start racing.

So he started to realize that nervous tissue isn't just about electrical

impulses. There are chemicals here as well. And that was a big finding. And then in the '50s this very young female researcher (she got her doctorate very early on) - got a sample of a new substance. There was a company that had found this new substance. And they called it hydroxytryptamine or in enteromine which now know is serotonin. And what she did is she thought about all that research that came before by Pavlov and this muscle – what they called the retractor muscle of the clam.



And what she figured out was that when she dripped this new stuff they found onto the muscle, it contracted. And that's actually how serotonin was found. And that's what it does in the digestive tract. It kind of moves and contracts the digestive system muscles as well which is how it has the affect there. And what's interesting is that this woman Betty Twarog’s paper actually didn't get published. It got held up. And then when some other male groups had published similar research then after that they published her paper, even though hers actually came first. So it was kind of an interesting world of issues because they didn't really believe in the electric versus the neurochemical system just yet. And they also didn't really believe in women being able to do that kind of work just yet. And she was so young and because it was almost heretical to say, "Well you know it's not electrical impulses. It's really this chemical that does these things."

Trudy Scott: [laughter] Dr. Peter Bongiorno: So there are a couple of reasons why it was held back. It's just

really amazing. But we finally did get the information and we learned that serotonin did that kind of work. And then in the '50s when they were researching tuberculosis drugs they found one of these tuberculosis drugs called isoniazid. They gave it to the TB patients. And they found that their TB didn't get better but for many of them, their depression was much less.

And then when the looked at the mechanism of that drug they

found out it was what they called a monoamine oxidase inhibitor which means it helps keep the serotonin around. And that's how they started realizing “hey this serotonin does work with mood in some way.” And when there's more of it around the people’s moods seem to be better.

Trudy Scott: Very interesting. I love hearing about this history. That's

fascinating, and the fact that her research was considered heretical. Dr. Peter Bongiorno: Yes. Trudy Scott: It's interesting though because often it does take a while for things

to be accepted. And I guess this is just one thing that just took a while to be accepted.

Dr. Peter Bongiorno: It did.



Trudy Scott: I'm glad it did. It's really good. [laughter] Dr. Peter Bongiorno: Yeah and it's interesting because another piece of heretical

information was that everyone thought the brain worked very differently from the rest of the body. I think that came from Descartes. Basically Descartes made this deal with the church way back when saying, "Okay well the spirit is your area. The brain and spirit is your area. And we'll deal with the body." So the mind and the body got very separated.

And we still haven't gotten it back together. So even though

people believe in things that happen in the body they don't believe that it really affects the brain. As a naturopath and as a holistic thinker – and not just myself but many other people who do the kind of work I do - we really believe that the brain and the body are all one.

And one really affects the other which is why serotonin is important even though most of it is made in the digestive tract. It does have a relationship to the brain and they do affect each other.

Trudy Scott: Absolutely and we've seen all this research now about the gut/brain

axis and how important that is. So taking this into consideration is definitely important. Let's talk about why it's considered this molecule of happiness.

Dr. Peter Bongiorno: First of all normal levels are associated with a fairly balanced and

happy mood. And even more research kind of focuses on the negatives. You know when there are low levels people have a lot more anxiety. People have a lot more panic attacks for example. I remember when I first started doing research in the early '90s after college. I was at Yale University and we were at a veteran's hospital.

And there were a lot of studies there on what they call tryptophan

depletion where they would give veterans – people with post-traumatic stress disorder and anxiety and things like that – diets very, very low in tryptophan or no tryptophan. And then they would study mood and how they reacted to things. So I remember learning very early on then that tryptophan - when it's not around the brain and the body can't make the serotonin - then mood really suffers as a result. And if you're predisposed to something like anxiety it's going to get much worse.

Trudy Scott: And then we do have some thoughts that serotonin is not actually a

factor when it comes to mood. One of my favorite integrative



holistic psychiatrists is Dr. Kelly Brogan - who's actually been on two of the Summits. I think she's fabulous. And I love the work that she does. We respectfully disagree in this area. And her opinion is that – she actually blogs about it – “Depression: it's not just serotonin.” She's very emphatic that it's not a factor when it comes to depression and also anxiety.

Dr. Peter Bongiorno: Right. Trudy Scott: And I'd love for you to just share your thoughts on that. Dr. Peter Bongiorno: Right. Well you know first of all I think Dr. Brogan's work is

exceptional and I fully support her work. I think she's amazing. And I do agree because I think what's happened in the conventional medical world is that serotonin has been so focused on - which is the reason why so many people aren't getting better with these drugs. I think serotonin is one factor of many though and certainly not one to be ignored either.

So I do think there's a relationship there. My interest is in treating

the whole person and really looking at everything. And I think Dr. Brogan's is certainly the same. So what I find that really works is when you work on the whole person, you work on their sleep, on the foods they're eating, on their digestion. If there's a lot of inflammation, if there's a lot of toxicity. And you give them the right nutrients and things to support the neurotransmitters that have to be made.

That’s when you really get the improvement. I think one of the

mistakes sometimes people make when they have issues – like let's say they have anxiety and they don't want to take an antianxiety medication. They'll say, "Well what's the natural supplement for it?" And then they'll look it up and they'll take that supplement. And then maybe they'll get some effect. Maybe they won't get any. And they'll say, "Well this doesn't work either."

And I think the mistake is that these neurotransmitters whether

they're serotonin or something else; in my opinion they're not the cause of the problem. They're really the symptom. And I think neurotransmitter levels like serotonin drop because all those other factors we just mentioned really quickly aren't in order. And the body is out of balance. And now that's showing up as a symptom as possibly low serotonin for that individual. For other people it might not be.

Trudy Scott: Right.



Dr. Peter Bongiorno: Again when you look at the research on antidepressants and you

see that serotonin reuptake inhibitors which artificially keep serotonin high by poisoning enzymes that break it down you find they work maybe 25-27 percent of the time. And so for many of those people it purely is a serotonin issue. But the majority it's not.

Trudy Scott: And that's a really good point. And the other thing that I want to

say about this is that there are many approaches to wellness. You know some people can focus on just making some of the food changes, adding in these nutrients. You've got the raw materials and that's going to obviously get you results. And then you're right - some people will focus just on the supplements. And you don't want to just do that. You want to look at everything.

And you know even though I'm bringing this question up I do want

to just say that I think it's good to challenge each other. I think when we were talking about this earlier before we got on the interview we were saying it's good. It's good to ask these questions. And it keeps me on my toes. Certainly when she started saying this I started reading more about it.

Dr. Peter Bongiorno: Yeah. Trudy Scott: And it makes me ask questions more. So I think it's all good.

We're all learning from each other. Dr. Peter Bongiorno: Oh gosh, yeah. Trudy Scott: In no way am I trying to discredit what someone else is doing. I

think it's good to have these healthy discussions and it's important to learn from each other. And she has amazing results with the work that she does. I just find that using supplements like 5-HTP and tryptophan; it gives people results right away while we're working on some of the underlying issues like the inflammation or the gut issues or the gluten issues or all of these other factors that are causing the problem in the first place.

Dr. Peter Bongiorno: Right. Trudy Scott: And you've said you use 5-HTP and tryptophan in your dispensary

as well. Dr. Peter Bongiorno: Oh yeah. No question about it. And I do find when I want to get

people there a little bit faster working with those are excellent. Like I said especially for example for sleep; you know a lot of



people with anxiety have sleep issues. And tryptophan is really wonderful especially for helping people stay asleep. About 2:00 AM, 3:00 AM, or 4:00 AM they're waking up. You know a dose a tryptophan 500 to 2,000 milligrams can be very, very helpful to help people stay asleep which is something that's hard to do even with medications.

Sometimes it's very, very hard to get people to stay asleep. And

tryptophan is one of those things that really help do that. And I finally get people sleeping. Then the daytime anxiety gets better.

But even 5-HTP as well, which gets converted nicely to tryptophan; it's a wonderful way to support that serotonin pathway. So when it truly is a serotonin issue you will see them get there a bit faster. And the nice thing about these things is unlike the drugs you don't really get the side effects.

In fact you know tryptophan or 5-HTP have studies in helping

people with weight loss whereas those medications tend to allow people to gain weight so much faster. So it seems like there's a lot more benefit than anything else.

Trudy Scott: Yep, I would agree. I see amazing results. And people can't

believe how quickly they get results and how quickly they feel better, which I think is great. Because when you're feeling so anxious or you're feeling so depressed you often lose hope. And I just find that using these targeted individual amino acids give people results and they feel hopeful. And they're feeling a little bit better right away.

And I like that you say that it helps them to get there a little bit

faster which is what we want to do. And we're probably going to get there in a roundabout way. If we didn't use them it's going to take a little bit longer.

Dr. Peter Bongiorno: That's true. Trudy Scott: But why not get people feeling better quicker which is what I'm all

about? Dr. Peter Bongiorno: Yeah and I also do love using acupuncture for that purpose too

sometimes. You know sometimes I'll use that for patients who don't want to take any supplements or drugs. And I also find acupuncture is a nice way to help people feel better a little quicker too.



Trudy Scott: That's interesting. Tell me a little bit about that. Dr. Peter Bongiorno: Well I'm also an acupuncturist so I do a lot of acupuncture in my

practice. Oftentimes with these holistic programs we work on, I'm also doing acupuncture at the same time. You know it's interesting for me because many years ago I had fairly terrific anxiety and sleep problems. And acupuncture was one of the things that brought me down three notches. Before then I had no interest in it either. And then I ended up deciding to learn it because I thought it was such a beautiful tool.

So I had personal experience in how it was helpful. And I've

definitely seen it with many patients. You know in Chinese medicine when your body's energy is out of balance within itself or when it's out of balance with the world around you that's when things like emotional issues can come up. Using those needles to kind of rebalance things is just a really wonderful, noninvasive, gentle way to kind of bring things back.

And there are a lot of studies about how that hypothalamic-

pituitary-adrenal axis which is the stress system of the body, how it really calms down beautifully and rebalances with acupuncture. So I highly recommend it.

Trudy Scott: Right. I'm glad you brought that up. That's a good one. Now you

mentioned the studies on the HPA axis. What about this - are you aware of any studies saying how acupuncture can possibly change neurotransmitter imbalances or have you not gotten to that point yet?

Dr. Peter Bongiorno: You know there are some studies about it. They're looking into the

mechanisms of it and the first set of studies is probably more about how they can increase some sort of opioids. And there are studies about it working with epinephrine. I'd have to look at serotonin specifically but I would venture to guess that it's pretty likely that they're there. I mean there are so many studies about acupuncture now - and the benefits.

Trudy Scott: And when you mentioned the opioids; that is where the

acupuncture seems to be well-written up - in terms of being effective for pain. So if it's working in that area you could assume that it's going to work in other areas as well.

Dr. Peter Bongiorno: Right exactly. You know it's interesting because we have this

neural net that runs in the fascia system. There are all these nerves



where our muscles are. And all those nerves in that net connect to all the other nerves inside our body. The research is starting to think that that's really how it's accessing the different areas. You do a point let's say on your leg and it affects your mood. How is that? So now they're starting to realize that this neural net is very connected and that when they do acupuncture studies they study the real point versus what they call sham point.

Meaning a point that's not a real point in the Chinese medicine,

acupuncture system. And what they find is that the real points really have physiologic change where those fake points aren't doing anything. So they're starting to realize this stuff really works.

Trudy Scott: Very interesting. I love it. Love it when we bring new things in.

Going back to the 5-HTP/tryptophan discussion tell us a little bit about when you may use one versus the other.

Dr. Peter Bongiorno: Right, that's a great question. Well like I said tryptophan for sleep

– and this has just been really my experience. And actually I remember maybe 15 years ago when I was in school Alan Gaby was one of my teachers who's well known in nutrient therapeutics. He would talk about how he found tryptophan was much better for getting people to stay asleep where 5-HTP was more about having people lower anxiety during the day. And to tell you the truth I do see that in my own practice.

I see that I'll tend to use more tryptophan at night. There seems to

be more of a sedative effect with tryptophan, where 5-HTP doesn't seem to have as much of that affect. So it's good to calm people down but it's not really very much sedating at all. You know both are wonderful for anxiety. So it's not to say that I won't use tryptophan during the day but I tend to use tryptophan more at night and the 5-HTP during the day for anxiety.

Trudy Scott: Okay. Yeah I would agree with that. Tryptophan at night is

fabulous. And some people can get away with doing it in the day. But sometimes it does make them a little bit more sleepy. And interestingly enough there are few people who find the tryptophan doesn't work and the 5-HTP does. So I definitely think it's very individualized.

Dr. Peter Bongiorno: Absolutely, yeah no question about it. And I'll do that. If the

tryptophan doesn't work then I will switch to try the 5-HTP and vice versa.



Trudy Scott: Yes. It's very individualized. Dr. Peter Bongiorno: I find tryptophan during the day especially with young women who

have other issues like eating disorder issues; it can be very valuable to kind of help balance that a little bit. So there are certain cases where I will individualize and kind of switch the thinking on how I use them.

Trudy Scott: Yes, definitely. And then when you're talking about the eating

disorders. This is because people with low serotonin can have the cravings often in the evening. And it helps in that area as well.

Dr. Peter Bongiorno: Right, exactly, along with some zinc. Zinc is really wonderful to

go along with the tryptophan for that purpose. Trudy Scott: Yes I'm a big fan of zinc. And zinc is a big factor when it comes

to anxiety as well. While we're talking about this, since you mentioned zinc, what about some of the other co-factors that you like to use when it comes to 5-HTP and tryptophan?

Dr. Peter Bongiorno: Sure. Well yeah when I'm using 5-HTP and when I'm using

tryptophan, besides zinc, probably the other ones that come to mind are in the B vitamin family like riboflavin, niacin, and niacinamide, and vitamin B6. When it comes to vitamin B6 I like using the active form which is pyridoxal 5-phosphate. And also a good general multivitamin as well because the truth is we definitely don't understand all the factors involved.

We know those B vitamins are. We know zinc and probably a few

other things are pretty clear. But chances are they're all involved at some level right? This is all one big stew that we have in there. So I like to also make sure that there's a multiple vitamin as a part of it.

Trudy Scott: Great. Yes I would agree with you on that one. Now going back

to the 5-HTP I'm curious if you have any thoughts on using 5-HTP if someone does have high cortisol based on a saliva adrenal test. I've seen one study that shows that 5-HTP can actually raise cortisol. And I'm wondering if you would not use 5-HTP in that instance.

Dr. Peter Bongiorno: You know it depends on the patient. I haven't in my own practice

because I usually run cortisol tests so I have a cortisol on all my patients with anxiety. And I haven't really seen 5-HTP to become a problem. But you know when I run the cortisol test I also like to see is cortisol high throughout the whole day? Is it high in the



morning and then shoots down the rest of the day? Is it low most of the day and then comes up at night? So when is it really high?

And then I try to work on that issue first. So in other words if it's

high at night then I'm going to want to work on things that bring down cortisol at night. And if it's low in the morning and high at night then we might even give them things like light therapy and things in the morning that help bring up their serotonin and their cortisol properly so that it comes down at night. To be fair I’m also doing a few things at the same time.

But I haven't really seen 5-HTP have a dramatic effect on cortisol

that way – at least in practice. Trudy Scott: Okay. Good to get that feedback. And I'm glad you mentioned

light therapy as well because we're talking about 5-HTP and tryptophan here but there are many other ways that we can impact serotonin levels. I love light therapy. I actually just finished reading Dr. Norman Rosenthal's book Winter Blues. He was a South African who moved to New York City actually and discovered that every winter he would get miserable.

You probably are familiar with his research on light therapy and

how amazing it is for mood and raising serotonin. It's a really good story on how someone lived it and did something about it.

Dr. Peter Bongiorno: Yeah light therapy is fantastic – also for raising cortisol at the right

time. Even eating patterns will help affect that too. And then also along with that is exercise. You know exercise itself increases tryptophan in the brain. And exercise, especially in the morning: get up, go out in the sunlight, go for a walk or a run or something like that. It's excellent to help stabilize your cortisol and raise your serotonin for the day.

Trudy Scott: Beautiful. I love it. Before we move onto the next topic, one more

question on tryptophan. And that is could you just touch on some of the history of tryptophan and some people being concerned about using it because of the history?

Dr. Peter Bongiorno: Oh yeah. Well you know and it's interesting because if you look at

places like WebMD they still talk about this as if it's a fact. And that's too bad because I think they're scaring a lot of people off. Of course WebMD is sponsored by who they're sponsored by. So I don't know if they have much interest in not scaring people off from supplements right? But yeah many years ago – about 20-25 years ago – there was a lot of misinformation about it.



In 1989 there was this condition called eosinophilia-myalgia

syndrome. And what happened was a number of individuals became ill after they took tryptophan. They had some joint pain. There were a lot of muscle issues, high fever, swelling in the arms and legs, breath shortness – all these things – in about 1,000 people. And 30 people died from it which is of course very, very sad. And at that time it was attributed to tryptophan.

In fact when I was at the National Institutes of Health – I was at

the mental health institute doing research. And there was a doctor there named Esther Sternberg who was one of the people on the panels. And she was actually in my lab. So I heard a little bit of this information firsthand because she was one of the people testifying with the FDA. And what was really shown was that tryptophan had absolutely nothing to do with those deaths.

It was a company that shouldn't have been making supplements

and there were bacteria that were introduced. And that's what actually caused that EMS syndrome. And even though they banned the tryptophan for a number of years thereafter it had absolutely nothing to do with it. And then when they brought tryptophan back probably about 10-12 years ago now into the U.S. there have been absolutely no problems with it since.

Trudy Scott: Great. And it's so interesting that you heard someone who had

been involved in it. And you heard firsthand from them. It's good to hear that you say that some of these websites are scaring people off. But it amazes me that some of these sites are saying it's still not available and you still need a prescription –

Dr. Peter Bongiorno: Right. Trudy Scott: - which is so outdated. It really is. Dr. Peter Bongiorno: And I wonder is it outdated or is it really just because the

advertising is so heavy from the pharmaceutical industry. They lose a lot of money if somebody can buy something like tryptophan over the counter and feel better. I don't think it's just because they're not paying attention and because it's outdated. They pay people a lot of money – especially WebMD. I mean it's probably the number one medically related site in the world.

And it's unrealistic to think that they're not updating that and not

looking at that and making a decision about that.



Trudy Scott: Good point. And the other aspect of this that I find even more interesting is that there are still some holistic health practitioners who say that it's not good. And even some really good reputable supplement companies that make professional grade supplements that still don't feel like it's okay to use tryptophan. I've seen some really nice free form amino acid blends that contain all the amino acids and they leave out tryptophan, which is crazy to me.

We know when you do these studies where you make people

become tryptophan depleted they actually have problems. So to me that's concerning. And then some of them will just offer 5-HTP and not offer the tryptophan. So I find it unusual that there are still some people in our world who still are not okay with the whole tryptophan thing. I just wanted to bring it up because I know perhaps we'll hear other people say things like this.

I appreciate hearing your perspective. Dr. Peter Bongiorno: Yeah. I mention that in my books for that very reason because I

just want people to have that side of the story and make sure that they're clear about that when they make their decision.

Trudy Scott: Yes. And the other thing that I think people need to realize is that

before tryptophan was banned it was used in the mental health world by psychiatrists. Psychiatrists were prescribing it weren't they?

Dr. Peter Bongiorno: Sure they were. I mean at that point it was probably dwindling

because Prozac had really come onto its own. Once these antidepressants started being produced the research money was put into that and people stopped studying things like 5-HTP and tryptophan. So I think it was already kind of coming down a bit. But yes people were using it because they knew it was effective.

Trudy Scott: Yes and interestingly enough - the fact that you mentioned Prozac

– I interviewed Jeffery Smith on one of the prior The Anxiety Summit about genetically modified foods. He's got a section in his book Genetic Roulette talking about this because his colleague had information that thought that it was genetically modified and that's what was causing the problem. And that it was a conspiracy theory because Prozac was coming onto the market and they needed to get rid of the competition. So I think that whole aspect is very interesting too. [laughter]

Dr. Peter Bongiorno: [laughter] That is interesting. It's quite possible.



Trudy Scott: So let's talk about something else that I find fascinating. I've recently been reading some studies on autism and oxytocin and how low levels of oxytocin can be associated with social anxiety. And I just think it's so interesting. And you talk about oxytocin in your book. And you talk about how it's connected to serotonin and the 5-HT1A receptor. Can you talk a little bit about that?

Dr. Peter Bongiorno: Yeah well oxytocin is one of those hormones that is now starting to

get more and more press. It's one of those neurotransmitters that is really just for feeling good. Some people call it the neurotransmitter of love. When you fall in love you feel a lot of oxytocin. When you get a hug there's oxytocin released. When you're preparing food and you smell it and you're in a calm environment oxytocin is increased and getting massaged. Any kind of good therapeutic touch increases oxytocin - sexual activity.

And it does just make you feel really good. What we're starting to realize is that there is a strong relationship between oxytocin and serotonin. There is actually a study that came out of Italy from the University of Pisa. And what was shown is that serotonin seems to really enhance oxytocin release and likely vice versa. So there's a strong relationship between the two. And one seems to help the other very much. You know when I work with my patients I talk about oxytocin as well and I talk about all those things I just mentioned and how important it is to work on those things because there seems to be a strong relationship. In fact now they're even starting to think some of the drugs and things that work on serotonin also seem to increase oxytocin release as well. There is a strong relationship between the two. Sometimes I'll use lithium orotate as a supplement for patients with anxiety. And lithium is also known to increase oxytocin. So my guess is there is a relationship to serotonin too. And all those things that we talked about also build a better brain. It helps the brain repair and increases something called brain-derived neurotrophic factor which helps the brain repair and create more serotonin. All these things are just so wonderfully linked. That's why, again, doing them all in combination seems to have the best effect.

Trudy Scott: I love it. And I want to come back to lithium orotate in a second. But the other thing that I saw that seems to help with oxytocin release is zinc. And you had mentioned zinc being important when



it comes to serotonin boosting and overall health. It is lovely how it all works together. The body is just so interesting.

Dr. Peter Bongiorno: Yeah exactly. And that's why I like giving people a little bit of

everything and also why I don't love high dosing anything unless there's a specific reason or a therapeutic purposes. Typically even with natural things when you give a lot of something it's not necessarily better. And my concern is that sometimes it might back up certain pathways because they all are connected. So it's nice to just gently support the body with the things it needs from a whole lot of angles at the same time.

Trudy Scott: Absolutely. So let's talk a little bit about lithium because I also

love lithium. And when people hear the word "lithium" they often think, "Oh my gosh, bi-polar disorder. I don't want to talk about lithium."

Dr. Peter Bongiorno: Right. Trudy Scott: And you have to educate them that the lithium that we're talking

about is different from the lithium that they know about. Dr. Peter Bongiorno: That's right. Trudy Scott: So tell us about lithium. Dr. Peter Bongiorno: Lithium has been used for many, many years – the supplement

form. So lithium carbonate is the drug form and it's a very, very strong medication. And usually you've got to take heavy doses because that's the only way to get it into the brain. With lithium supplements like orotate or lithium citrate you use much, much lower doses. And it actually gets into the brain much easier. So you don't need the higher doses that cause those side effects.

And it's a wonderful supplement because it really seems to help a

lot of processes in the brain. It helps the brain repair, like I mentioned before: brain-derived neurotrophic factor. People who take that seem to have better repair mechanisms in the brain. It helps produce more oxytocin. It seems to help production of serotonin as well. It also helps in the GABA system, which is gamma-aminobutyric acid, which is the calming amino acid in the brain.

For many people with anxiety it's GABA that can be very low. So

it supports that system. And it also increases something in the brain called glutathione which is one of the master antioxidants



that we need for decreasing inflammation and clearing out glutamate which is a toxin that the brain naturally makes. So it does so many different things. And I tell you it's something that I feel like I've come to kind of late. It's only the past few years that I've really started looking at it.

I think also because I had that kind of preconceived notion about

the lithium the drug. And this is a different lithium. It's a much kinder, much gentler lithium. And to be safe – and when I give patients lithium – lithium orotate the supplement – I will check blood levels. And you can also do hair analysis levels and check. And I've never actually seen it get high. And I've certainly never seen anyone have any problems with their kidney or their thyroid as well.

I think it's good to check. There's nothing wrong with that. But

certainly I've never see it. And the practitioners I know who also work with have said the same thing – no problem.

Trudy Scott: Great. Tell us how much you like to use. Dr. Peter Bongiorno: Usually I start with a low dose like 5 milligrams, maybe 10 – up to

20 milligrams a day, so not a lot. Trudy Scott: Yeah that's what I find to be very helpful. And I do find it to be

very helpful in terms of mood stabilization if someone's got ups and downs.

Dr. Peter Bongiorno: Yes. Trudy Scott: And I find that the tryptophan and the 5-HTP and the other amino

acids work more effectively because you don't have the sort of up and down where you've got this moving goal post. And then it just evens out the moods. It seems to work better when people do have the mood swings.

Dr. Peter Bongiorno: That's right. Trudy Scott: I've seen some articles where there is talk about how it helps with

addictions as well and focus issues. So the fact that you're talking about brain repair - I think is wonderful. I'd love to find out from you - do you know what the mechanism of action is in terms of how it helps with GABA?



Dr. Peter Bongiorno: You know I would have to look that up. I know it does do that. I know it works at the receptor level for more than one of the GABA receptors.

Trudy Scott: Okay. Dr. Peter Bongiorno: But I can't give you more specifics than that. I'd have to look it up. Trudy Scott: Okay well that's good to know. I'm curious. I'm going to have to

go and look too. [laughter] Dr. Peter Bongiorno: You know it's interesting because – Trudy Scott: I've heard about the GABA connection so that's interesting. Dr. Peter Bongiorno: Yeah I could send you some of the references. I know I have

them. Trudy Scott: Okay. We'll share then. Dr. Peter Bongiorno: I'll be happy to do that. Trudy Scott: That would be great. Dr. Peter Bongiorno: And you know it's interesting because in I think the '50s – up until

the 1950's – something like that – 7-UP was really lithiated water. They called it that because it kind of picked you up and made you happier. And there are so many studies about places where lithium levels are reasonable in the water people have a much better mood, lower suicide rates. So there is just a lot of information over a long time about how lithium can be supportive for our mood.

Trudy Scott: Yes and we need to think of it like we think of other minerals like

zinc. Zinc is a mineral. We get low in it. We need it. Dr. Peter Bongiorno: Exactly. Trudy Scott: And people have got this sort of fear factor around lithium because

of the drug. Dr. Peter Bongiorno: Right. Trudy Scott: And I'm also finding it fascinating and finding it more and more

useful. And personally I use it. I found it to be very useful once I got into menopause. It's just been fabulous for me. And I'm finding a lot of my clients really enjoy it too. So it's a good one.



I'd love to just hear from you a little bit about the blood testing. Can you tell us what you actually test? What are you asking for? And it is a regular lab or are you doing it at one of the functional medicine labs?

Dr. Peter Bongiorno: Yeah you can just check for serum levels in the blood just to see.

And that's really just something that's just a vestige from what they do with the drug because the drug obviously uses much higher levels that you have to check. You get past a certain point and it becomes dangerous for different organ systems. Again like I said when you use the supplement you're using such lower, lower doses that unless somebody really has an issue with how they process or hold it it's virtually impossible to increase levels to toxic levels.

Trudy Scott: Okay, good to know. Now in terms of doing this testing would

you do it before someone starts supplementing and then again afterwards?

Dr. Peter Bongiorno: I mean that's ideal. It's ideal to do if you could a hair analysis and

do a blood test just to check. And typically what I've noticed, especially with the hair analysis, the lithium is low or undetectable. And that's a clue that they probably could do well with it.

Trudy Scott: Okay that's good to know. And then the lab reference ranges for

the serum lithium (in the blood); would that be something you would use? Or are you looking for in the middle or low end?

Dr. Peter Bongiorno: Yeah - no the reference range is just fine. Trudy Scott: Okay. Dr. Peter Bongiorno: You want low to mid. The idea is you just don't want it too high.

You want it there but not too high. Trudy Scott: Yeah good point. And I know they do test. They use this test for

people who are on the lithium carbonate – the drug form. Dr. Peter Bongiorno: Exactly, right. Trudy Scott: Okay, excellent. Dr. Peter Bongiorno: Yeah and that's basically a safety measure, you know just to follow

proper protocol with things like this, especially because people are concerned. They do know about it. So it's good to just run it. And I think it eases everybody's mind.



Trudy Scott: And then do you have them run it every three months? Or once you've done it a few times do you find that - well because they're processing it well you don't think it's an issue?

Dr. Peter Bongiorno: Yeah every three months is a good way to start – for maybe up to a

year. And then after that you can space it out every six months. Trudy Scott: Okay. Dr. Peter Bongiorno: To tell you the truth I don't typically keep my patients on it longer

than a year or so because by then we've really used other things and we've been able to get to the point where they can get off the supplements.

Trudy Scott: Good point. And one other thing that I just thought about lithium

is that Dr. Amy Yasko talks about lithium a lot in terms of methylation support. And you talked about glutathione there so I'm guessing that's where it might be helping in the methylation pathway.

Dr. Peter Bongiorno: Yes that's quite possible. Yeah that makes sense. It's so

connected. I'm just so impressed by your vast knowledge and being able to connect all these things together. It's a really great conversation. Thank you.

Trudy Scott: Oh good. Well I'm enjoying it too. I love doing these interviews

and I love sharing what other people know. And I love learning myself. It's great so thank you as well. [laughter] I'm having fun too.

Dr. Peter Bongiorno: Oh good. Well it sounds like it. That's really the whole point of

all this right? And when I think about it when I work with patients we focus so much on food and supplements and digestion. But really the whole point is that people can feel good so they can go out and live the life they want and do things that make them happy. That's really the end purpose of all this. It's not about a particular vitamin or anything else or what I think. It's really just about them feeling better so they can live their life the way the want to and be happy.

Trudy Scott: I love it. And I'm totally on board with that. We want people to

feel good. They deserve to feel their absolute best. Dr. Peter Bongiorno: Oh amen, they certainly do.



Trudy Scott: If we can help them get there that's what we want to do. I love it. Thank you for saying that. So earlier on we talked about the serotonin and the gut. Let's talk a little bit more about the role it plays in digestion. And I'd love to just start with a question that ties back to an interview that I had with Dr. Allison Siebecker. She's the SIBO or small intestinal bacterial overgrowth expert.

Dr. Peter Bongiorno: Oh yes. Trudy Scott: I had asked her about what her thoughts were on serotonin and the

fact that it impacts gut motility. And we're seeing an increase in depression and anxiety and possible low serotonin. And a lot of people seem to now say, "Yes I've got SIBO." Or, "They've tested and I do have SIBO." So I'd love to just hear your thoughts on this connection between serotonin and gut motility.

Dr. Peter Bongiorno: Sure. Well it's interesting because the first thought I think a lot of

people in the conventional world would say is, "Yeah there's a lot of serotonin in the gut, but the serotonin that's important for your mood is the one that's in the brain." And, "Serotonin in the gut doesn't get to the serotonin in the brain." I certainly disagree with that. I think there's some truth to it. I think if people are very, very healthy and their gut lining is very tight and they don't have leaky gut, and their brain barrier lining is very tight and they don't have leaky brain – which is a whole other topic – then that might be true.

But in most cases people who have those things very tight don't

have mood issues and don't have too many health problems. So the patients who usually have mood issues and anxiety usually have one or both like a leaky gut or a gut dysbiosis or the small intestine bacteria overgrowth or maybe a few of those things at the same time. And/or they might even have a little bit of leaky brain too where things that get into the bloodstream from the digestive tract end up at some level in the brain and is contributing to inflammation.

And that's certainly been shown. You know there are a lot of

studies. There's a fellow out of Italy and I'm blanking on his name right now. He did studies where you could see that things that come from the digestive tract end up in the liver, stimulate Kupffer cells which are immune cells in the liver which go through the bloodstream and end up stimulating microglial cells in the brain contributing to inflammation.



And we talked about the strong relationship between serotonin and inflammation as well, so all of that is very, very connected. I'm not sure if I answered the question. [laughter]

Trudy Scott: Well you definitely said something interesting. The study that you mentioned about impacting the liver and then impacting the brain and inflammation: that's fascinating. Let me follow on my question and just make sure that I get the answer I'm looking for. [laughter]

Dr. Peter Bongiorno: Okay. [laughter] Trudy Scott: What I’m trying to find out is if you have seen a connection

between your patients who have small intestine bacteria overgrowth and also possibly have the anxiety and the depression. And when they get on the serotonin support – either tryptophan or 5-HTP or the other approaches that you use – are you seeing improved symptoms in terms of the SIBO and the gut motility?

Dr. Peter Bongiorno: Sure. Well I would say in the patients I've seen the majority it's

better to treat the digestive issue first – treat the SIBO. And then people respond better to things like tryptophan and then 5-HTP. If you don't get the gut issues the vast majority of serotonin that's not being produced properly will absolutely affect the results that you're going to get in the long term. I was just thinking there was a study. I just saw it today actually. I think it was published early this month.

And what they did was they did a study on mice. It was from

Caltech I think. They did this study on mice that didn't have any gut flora. They somehow were able to eradicate the gut flora. And what they found was that 60 percent of the serotonin was decreased in those mice. And in other studies on mice and the microbiome suggest that there's a very strong relationship between mood and the microbiome. In fact there are some human studies on that too because it seems like the microbiome - when it's healthy - it produces GABA at the right levels and serotonin at the right levels.

So there's really a strong relationship between how healthy the

digestive tract is and a person's mood and whether they're going to be much more prone to anxiety. So my thought is if we run the test for SIBO and we find out that it's positive then that's got to be something we have to work on to get their gut back in balance – to get their mood back in balance.



Trudy Scott: Yes and I would agree with that. And I love all the research we're seeing on the microbiome. I actually interviewed Dr. Dinan....

Dr. Peter Bongiorno: Yeah every day. I'm sorry what's that? Trudy Scott: Say that again. Dr. Peter Bongiorno: Yeah no I was saying every day I feel like it's coming out more

and more. I can't keep up with it. It's wonderful. Trudy Scott: I know. Dr. Ted Dinan was on Season 2. He's the researcher who

coined psychobiotics. I just looked at the research he's done just this year - up till now. He's got 11 papers just on the microbiome. So it's fascinating. It really is.

Dr. Peter Bongiorno: Yeah I believe it. It's amazing. Trudy Scott: We've got to support the gut, absolutely. So you haven't really

found that if someone does have SIBO adding in the tryptophan or the 5-HTP would help them?

Dr. Peter Bongiorno: The problem is there's so much going on in that gut. Trudy Scott: You don't know. Dr. Peter Bongiorno: I think it's just hard to get it through sometimes. Trudy Scott: Okay, good point. Dr. Peter Bongiorno: I think in cases like that it's certainly much more challenging at the

minimum. So treating the gut is definitely an important part of getting to the root cause.

Trudy Scott: Yes, definitely. So what about inflammation and serotonin?

We've kind of touched on inflammation in a few points earlier but what more can you share directly related to inflammation?

Dr. Peter Bongiorno: Well when there's a lot of inflammation in the body it will

definitely adversely affect serotonin levels. And when serotonin levels are down interestingly it also weakens immune function. So they kind of affect each other I think that way. And a lot of things will affect the immune system that will affect serotonin. So in other words toxins – again endotoxins – the things that are in the gut like bacteria that are producing all these endotoxins and these waste materials; that will affect it.



Estrogen levels when they're out of balance; that'll affect it. And then even toxins that we're taking in from pollution and things like that will also affect it as well. And when the mast cells release histamine and there's a lot of inflammation it'll also increase things like vasoconstriction and clotting and all these issues with the vessels, creating all this permeability in your blood vessels and increase more gut inflammation. And it depends on the timing because actually in the short term when there's a lot of inflammation you could actually end up raising serotonin levels.

And that's been shown, for example, to be associated with things

like appendicitis. In fact high serotonin levels are considered a marker of appendicitis. But in the long term, you know over years and years and years, it seems like all that inflammation becomes associated with low serotonin levels. When you read that research it depends on what timeframe you're talking about.

Trudy Scott: That's so interesting. Tell me about the high serotonin and the

appendicitis. Dr. Peter Bongiorno: Yeah there are studies that suggest or show that when serotonin

levels are high that that's a marker of appendicitis. I remember this I something I learned a couple of years ago.

Trudy Scott: Very, very interesting. Dr. Peter Bongiorno: Yeah. Trudy Scott: And then going back to the whole inflammation issue - I've heard

some practitioners talk about one of the concerns that they have with supplementing with tryptophan when someone does have a lot of inflammation is that the tryptophan can go down the wrong pathway and not actually make serotonin. But I can actually be redirected and you can end up with high levels of quinolinic acid which can be problematic. Any comments on that?

Dr. Peter Bongiorno: You know I haven't really read that myself. I'm thinking about that

in terms of pathways. I know when there's a lot of inflammation what tends to happen in general is you make more quinolinic acid and that increases neurotoxicity. And so what seems to happen is when there's less inflammation or there's more of what they call anti-inflammatory mediators that it seems to block the enzyme that creates that process. So to tell you the truth I'm not so sure if you're feeding the process so much with more tryptophan or it's just because all that inflammation is available to do that.



Trudy Scott: Okay. Dr. Peter Bongiorno: Yeah I can't say I've seen an aggravation of issues that way. There

are so many factors at play so it's always hard to know. But I think if we work on the things that help lower inflammation that's the safest thing to do whether we're giving tryptophan or not.

Trudy Scott: I agree. We've got to definitely work on inflammation. It's just a

factor in so many things: heart disease and cancer and mood and everything. We've got to get that inflammation down in the body which is where diet and all these other factors play such a great role. Good, I would definitely agree on that one. So let's see, what else do we want to talk about? I know you wanted to end with talking about the whole picture and the fact that serotonin just isn't one aspect.

And you kind of alluded to that at the beginning. Is there anything

else that you want to add on that topic? Dr. Peter Bongiorno: Yeah I mean I would say for people working with anxiety what I

see work in my practice is the basics. The basics always have to be there. Stress obviously is a very important piece. That stimulation from the outside of the brain stimulates the middle of the brain to create this stress response. And that can actually contribute to a lot of the physiology changes and the inflammation and all of that. So it's hard to say whether the inflammation is causing the mood issue and the gut problems or if the stress is or if the gut problems are causing the stress.

Trudy Scott: [laughter] Dr. Peter Bongiorno: Yeah it's a big loop. So what we have to do is work on all of it at

the same time because we may never know exactly where it all started. So I like to make sure people are working on their stress. When possible can we figure out how to lower stress? Are they doing things that make them happy? Or are there things they want to do in life they just feel they're not doing and they're not allowed to do? And how can we change that? You know that plays a big role in serotonin if you want to create good serotonin.

Making sure people are sleeping well. You know there are two

things. People aren't sleeping well and if they're not pooping every day - those are the first two things I like to work on.

Trudy Scott: [laughter]



Dr. Peter Bongiorno: Because nothing else matters if you're not pooping and getting rid of what you need to get rid of and assimilating your nutrients properly. And if you're not sleeping well it's very hard to repair things in the body, decrease inflammation, get the digestive system working well, and balance blood sugar.

We didn't talk about balancing blood sugar but that's such an important part of anxiety. When people's blood sugar is all up and down it's very, very hard to get anxiety under control.

So making sure people are exercising, make sure they're burning

those catecholamines as they're producing them. When we were in the wild and a bear came at you and you ran you made stress hormones, you felt anxious, and you burned them up. Now in today's modern society we get stressed out and we sit there. And they don't get burned up. And that will create imbalances. So in other words when your norepinephrine is really high that's going to really unbalance your serotonin for example.

So we need to burn those stress hormones and get our bodies

moving. And getting our bodies moving is important for the gut. And that's been shown that when you exercise you get this robust return of circulation to the gut which will help your serotonin. Again it's all related. So making sure we're exercising.

Doing things like we said before that promote oxytocin is really important: getting hugs and touch and love and social bonding.

And then using the right supplements too – making sure we're

getting the things that we need: a good multivitamin, those B vitamin cofactors we talked about, 5-HTP maybe, or tryptophan, maybe lithium, maybe a little bit of GABA. People just need to feel a little calmer quicker. You know there's a whole other list. Again the stress work, the sleep, the exercise, the right foods. I didn't mention that food is very important of course for best digestion to get the nutrients you need.

Promoting oxytocin and getting the nutrients we need as well

through supplementation. So if we do all those things together that's really the best opportunity to work on that whole web of information we just spent time talking about and getting an imbalance.

Trudy Scott: Wonderful. And this leads us perfectly into the gift that you have

for everyone which is a nice little report called 10 Ways to Balance



Serotonin Naturally. And folks can go to your website:drpeterbongiorno.com.

Dr. Peter Bongiorno: Yes that's correct. Yes drpeterbongiorno.com/serotonin. Trudy Scott: Perfect and we'll make sure that that link is on the speaker page

and on the blog that goes with this interview plus we'll share some of the links to some of the research that we talked about today so you can read a little bit further. This has been absolutely fantastic. I've thoroughly enjoyed every minute of it. And I know others who are listening have enjoyed it too. So thank you so much for sharing with us Dr. Bongiorno. It's been really, really great.

Dr. Peter Bongiorno: Well thank you so much for putting this together and sharing great

information. And thank you to the listeners because honestly the people who are interested in this and who are teaching themselves what they need to know to feel healthy; that's what changing medicine and that's what's allowing this to move forward. So thank you to everyone listening as well.

Trudy Scott: Really good point because if you listen and you learn and you take

charge of your health it's wonderful. And that's what we're trying to do with this. That's a really great thing to thank all the listeners because there are so many people who are just so interested in learning more. And having people like you get on and share your expertise so we can share this with more and more people is just wonderful. So thank you again for joining us. And thanks for all the fabulous work that you're doing.

I look forward to your next book. I believe your next book that's

coming out is going to be one focusing on anxiety. Dr. Peter Bongiorno: Yes and that'll be coming out in October on Red Wheel and Conari

Press as well. Trudy Scott: I can't wait. Dr. Peter Bongiorno: Look for that. Trudy Scott: I can't wait. It's been wonderful connecting with you and

interviewing you. And I look forward to future connections and learning more from you Dr. Bongiorno. It's been really great.

Dr. Peter Bongiorno: As do I. Have a great day.



Trudy Scott: Right. Thanks everyone for joining us. This is Trudy Scot signing off. Do join us for other fabulous interviews on The Anxiety Summit – Season 3.

Speaker blog: http://www.everywomanover29.com/blog/anxiety-summit-serotonin-anxiety-digestion-hormones/ Dr. Peter Bongiorno, ND, author of Holistic Therapies for Anxiety and Depression

Dr. Peter Bongiorno is co-medical director of InnerSource Natural Health and Acupuncture, a thriving practice with two clinics in New York (New York City and Long Island). He specializes in mood disorder and depression. Dr. Bongiorno teaches an integrative medicine elective at the Mount Sinai School of Medicine and also lectures at the Natural Gourmet Institute in New York City. He is an expert blogger for Psychology Today, and has appeared multiple times on national FOX news programs. He is current President of the NY Association of Naturopathic Physicians and, was chosen naturopathic physician of the year in New York State in 2008. Dr. Bongiorno is a major contributor to the Textbook of Natural Medicine and authored the 2010 textbook for physicians Healing Depression: Integrated Naturopathic and Conventional Therapies for Depression. He authored How Come They’re Happy and I’m Not - The Complete Natural Program for Healing Depression for Good (Red Wheel / Conari) and Holistic Therapies for Anxiety and Depression recently released by WW Norton. Peter loves running outside, playing the drums, making breakfast, and enjoying life with daughter Sophia and fellow naturopathic doctor Pina LoGiudice. Please join @drbongiorno on Facebook or learn more about him through InnerSourceHealth.com and drpeterbongiorno.com



Trudy Scott, CN, host of The Anxiety Summit, Food Mood expert and author of The Antianxiety Food Solution

Food Mood Expert Trudy Scott is a certified nutritionist on a mission to educate and empower anxious individuals worldwide about natural solutions for anxiety, stress and emotional eating. Trudy serves as a catalyst in bringing about life enhancing transformations that start with the healing powers of eating real whole food, using individually targeted supplementation and making simple lifestyle changes. She works primarily with women but the information she offers works equally well for men and children.

Trudy also presents nationally to nutrition and mental health professionals on food and mood, sharing all the recent research and how-to steps so they too can educate and empower their clients and patients.

Trudy is past president of the National Association of Nutrition Professionals. She was recipient of the 2012 Impact Award and currently serves as a Special Advisor to the Board of Directors. Trudy is a member of Alliance for Addiction Solutions and Anxiety and Depression Association of America. She was a nominee for the 2015 Scattergood Innovation Award and is a faculty advisor at Hawthorn University.

Trudy is the author of The Antianxiety Food Solution: How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood and End Cravings (New Harbinger 2011). She is also the host of the wildly popular Anxiety Summit, a virtual event where she interviews experts on nutritional solutions for anxiety.

Trudy is passionate about sharing the powerful food mood connection because she experienced the results first-hand, finding complete resolution of her anxiety and panic attacks. The information provided in The Anxiety Summit via the interviews, the blog posts, the website, the audio files and transcripts, the comments and all other means is for informational and educational purposes only and is not intended as a substitute for advice from your physician or other health care professional. You should consult with a healthcare professional before starting any diet, exercise, or supplementation program, before taking or stopping any medication, or if you have or suspect you may have a health problem.

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