dr. jessica petrusma, nd - the peanut...
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Dr. Jessica Petrusma, ND
Integrated Health Care 577 Ontario St., St. Catharines
Phone: 905-988-9160
Anxiety
Types
•GAD
•Social phobia
•Specific phobia
•OCD
•PTSD
•Panic Disorder
• Aldosterone• Adrenaline• Cortisol
1. Learning/memory2. Immune function3. Bone density/growth4. Testosterone & estrogen (skin and menses)5. Weight gain6. Blood pressure, cholesterol, heart disease risk
Naturopathic Medicine
“The art and science of disease diagnosis,
treatment and prevention using natural
therapies and gentle techniques to support and
stimulate the body’s ability to heal itself”
1. Nutrition 2. Lifestyle Counseling3. Botanicals4. Acupuncture5. Homeopathy
3 servings protein: meat, legumes, cheese, eggs
Healthy fats! 2 tbsp olive oil plus nuts/seeds
Nutrition• Unprocessed whole foods• Combination of Mediterranean
and Paleo Diet• Mindful eating
2:1 ratio
0 > 2 > 4 legs and lean
5-6 veggies, 2-3 fruits
Sweets (optional but hard to avoid)
1-3 servings of grains, starchy vegetables and dairy (diet dependent)
• Water, caffeine, fiber & protein
• 5 colour approach
Nutrition Supplementation
The Big 5 For Anxiety
1. Magnesium
2. B Vitamins
3. L – Theanine
4. Glycine
5. Gaba
1. Magnesium• Several Forms: Citrate, Bisglycinate, Oxide,
Carbonate, Malate, Sulfate, Threonate & Taurate
• Standard dose: 300-500mg 1-2x/d before bed
• Best absorbed when taken at night and combined
with an acid (fruit, meat)
• Food sources: brown rice, beans, nuts, seeds and
kelp.
2. B Vitamins• B3 – Niacin. Harmless Niacin Flush. 25mg–75mg(div)
or Niacinamide (non-flush) 500mg 1 – 2x/d
• B5 – Pantothenic acid. 150-500mg/d
• B6 – Pyridoxine. 50-100mg/d
• Food sources: Whole grains, Brewer’s yeast, Miso (a
Japanese soup stock), Marmite (a vegetable
concentrate paste), Liver & Rice bran soup
3. L-Theanine• Acts on GABA, Serotonin and Dopamine
• Adaptogen and changes brain wave stateo Increases alpha waves and decreases beta waves
• Standard dose: 200-300mg/d
• Food sources: Green tea (3 small cups/d), [black
tea]
4. Glycine• Helps regulate digestion & heal lining of intestines,
builds muscle, supports the immune system, helps
with sleep and calms the nerves
• Standard dose: 5g/d as powder
• Food sources: Bone broth, beans, spinach,
pumpkin, bananas, kiwis
5. GABA• Inhibitory Neurotransmitter
• Synthetic GABA supplement or supplement that supports GABA function
• Magnesium, L- Theanine, Glycine, Taurine, Kava Kava & PharmaGABA all work on the GABA system
• Standard dose: 200 - 500mg/d
• Food sources: spinach, brown rice, apples, broccoli, carrots, beans, onions, mushrooms, sweet potato, tomato, oatmeal, fermented foods (probiotics)
Note on Depression
• More than 50% of patients with anxiety also have depression
• 5HTP is a precursor for Serotonin (mood)
• 90% is naturally made in our intestines
• Cortisol depletes tryptophan which is used in 5HTP
Testing• Urinary testing
o Calming
• Serotonin
• GABA
• Glycine
• Taurine
o Stimulating
• Epinephrine
• Norepinephrine
• Glutamate
o Modulating
• Dopamine
• Salivary testingo Cortisol
o DHEA
Thorough history • Nature and onset of symptoms• Presence of comorbid medical
or psychiatric conditions
Physical exam to exclude endocrine, cardiac disorders and exclude substance abuse
Lab tests: CBC, LFT, GGT, TSH, and possible referral for ECG
Lifestyle Counseling
The Big 5 For Anxiety
1. Exercise
2. Time Management
3. Good Sleep Habits
4. Breathing Techniques
5. Meditation
1. Exercise
• Massive impact on mood, energy, performance at
school, sleep and self-esteem
• Increases GABA
• Yoga increased GABA levels by 27% in 1 hour
• Spend more time in nature
2. Time Management
• IEP – Individualized Education Plan
• Schedule the month with your child
• Break down large goals in to small steps to meet
deadlines
• Avoid being rushed and rushing your child
3. Sleep Hygiene1. Regular sleep-wake cycle
2. Quiet period before lights out
3. Dark and soundproofed, as much as possible
4. Avoid napping
5. Regular exercise
6. Avoid large meals shortly before bed
7. Turn clock face away and use alarm
8. Avoid caffeine, nicotine (esp > 7pm), alcohol
9. Keep electronics and homework out of bedroom
10. Sleep restriction to avg. sleep time of last week
4. Breathing Techniques
• Belly breathing
• Calming breath
• Alternate nostril breathing
• Can combine with techniques learned in Cognitive
Behavioural Therapy (CBT)
5. Meditation
• Stop, Breathe & Thinko Have an app especially for kids!
• Mindfulness training o A form of meditation that helps people focus attention on the present
and encourages a positive attitude towards that experience
BotanicalsThe Big 5 For Anxiety
1. Passiflora incarnata (Passion Flower)
2. Matricaria recutita (Chamomile)
3. Melissa officinalis (Lemon Balm)
4. Rhodiola rosea (Rhodiola)
5. Piper Methysticum (Kava Kava)
Actions:
• nervine
• anxiolytic
• antispasmodic
• anticonvulsant
• antioxidant
• aphrodisiac
• anodyne
• hypotensive
1. Passiflora incarnata(Passion Flower)
2. Matricaria recutita(Chamomile)
Actions:
• carminative
• antispasmodic
• antiemetic
• nervine
• vulnerary
• antiinflammatory
• antiulcerogenic
• gastroprotective
• antiseptic
• antiemetic
• antiallergic
• bitter
3. Melissa officinalis(Lemon Balm)
Actions:
• carminative
• antispasmodic
• nervine
• antidepressant (mild)
• antimicrobial
• antiviral
*Not to be taken if hypothyroidism*
4. Rhodiola rosea(Rhodiola)
Actions:
• adaptogen
• sedative
• antidepressant
• cardioprotective
• antiarrhythmic
• antihypertensive
• anticancer
• antiinflammatory
*Not to be taken at night or with antidepressants*
5. Piper Methysticum(Kava Kava)
Actions:
• nervine
• sedative
• anxiolytic
• antispasmodic
• muscle relaxant
• anodyne
• analgesic (urinary)
• antitussive
• anticonvulsant
• sialogogue
• diaphoretic*Not in pergnancy or if liver pathology*
Acupuncture
Acupuncture
• Can be combined well with
counseling & mindfulness training
Homeopathy• Gelsemium: Feels weak and may have some trembling. Feel
like the task ahead is too much.
• Argentum nitricum: Anticipatory anxiety, very nervous with diarrhea and flatulence.
• Lycopodium: Performs well but still has preceding anxiety. Afraid to look foolish in front of others.
• Aconite: Intensely scared and can’t sit still.
• Silica: Talking exhausts and causes anxiety, gets stuck and can never find the right words.
• Calc-carb: Anxiety about health and despair of recovery.
My Top 10 Products1. Individually prepared mix of botanicals
2. Zen Theanine by AOR
3. PharmaGABA-100 by Thorne
4. RelaxMax by Xymogen
5. Mg Citrate powder by Natural Factors
6. Rhodiola by Cytomatrix or AOR
7. Best Rest by Pure Encapsulations
8. Niacin (B3) by Natural Factors
9. Kava Kava by NOW
10. Neurapas balance by Pascoe (homeopathic)