Question: Hi Lyle. I happened upon your site while researching the connection of dieting leading to anxiety. I am prone to anxiety and panic attacks and have been on zoloft 50mg for years. As of mid November I did Isagenix 30 day program with one day a week of a cleanse. The cleanse days were horrible for me as I don’t do well on not eating. Anywhoo…after I completed the month of cutting out a lot of carbs and drinking their whey protein shakes 1-2x a day, drinking BCAA’s and eating healthy, I had a major panic attack about a week and a half later. It was odd. I hadn’t had one in years. I am very active.
I teach Cycle, Boot Camp and am a long distance runner. I workout 5-7 days a week. This panic attack was about 4 weeks ago. Since then, I have had to increase the Zoloft to 75mg and I’m trying to get through the upstart side effects (ironically, agitation and anxiety increased) that I can’t seem to shake just yet (4-6 weeks to feel a difference. I am on week 3). I just wanted to get your opinion on the correlation between dieting and anxiety. I am curious if the addition of adding Whey protein with amino acids and BCAA’s once / twice a day caused this issue. I am SO frustrated to not feel normal again and it has definitely hindered my outlet – running. Thoughts would be greatly appreciated! Thanks!
Answer: Ok, I swear this will be a short one. I addressed this a lot of this within the context of depression as well and you can go read that for most of what you need to know. Tangentially, re-reading that piece, I couldn’t honestly write it today. I suspect I was mired in a bunch of research on the topic because most of those details are completely wiped from my brain. In any case, reading that will give at least some background to this question along with some general concepts of how to address it.
Now, first let me state that anxiety spans a lot of different types of things; interestingly, and suggesting that serotonin plays a role in many of them is the fact that Selective Serotonin Reuptake Inhitibors (SSRI’s), drugs that raise serotonin in the nerve space by preventing it’s re-uptake appear to have major benefit for treatment of anxiety. Zoloft which you mentioned being on is an SSRI (and note that SSRI’s take 3-4 weeks to really kick in for some reason). As well you didn’t mention if you’re still on a low-carbohydrate diet.
But let me talk briefly about anxiety. Years ago when I was way up my butt into neurochemistry, serotonin gave me the worst problem in terms of figuring out what in the hell it actually did and here’s why. Low serotonin levels can be associated with depression but also mania (which trust me are at opposite ends of the continuum), anxiety, aggression and a whole host of conditions that have absolutely nothing to do with one another. But low serotonin is frequently present (and the treatments are broadly the same) in all of them. But why?
The reason is that serotonin per se isn’t causing any of these conditions. Rather, it’s either inhibiting or allowing them to occur. Serotonin turns out to be a general inhibitory neurochemical. When it’s high it tends to generally inhibit behaviors; when it drops it stops doing this. Of some interest, when prey animals are put in front of their predator, they get a huge burst of serotonin and freeze in place (note that this depends on how close they are to the predator; if they are far enough away they run, if they are too close they fight). But serotonin is attempting to inhibit movement. This actually raises the question of why serotonin seems to be so involved in sleep and half of me thinks it’s that serotonin is actually paralyzing people in an odd way (the other half of me thinks I’m an absolute idiot for thinking that and note that sleep is insanely complicated neurochemically). Mind you, serotonin converts to melatonin which is probably the mechanism at work here.
And the same appears to be what’s going on here. If someone is prone to aggression and serotonin drops, their aggression manifests. IF someone is prone to depression and serotonin drops, their depression manifests (note that high serotonin can also be associated with depression). If they are prone to mania and serotonin drops…. And the same would occur with anxiety. If someone is prone to anxiety and serotonin drops…well, I think you can finish this sentence.
So broadly speaking, if you’re prone to this type of thing, either
a. Don’t go on low carbs (generally less then 100 g/day is where issues start)
b. Find one of those high tryptophan proteins I mentioned in the depression piece
c. Take either L-trypotphan or 5-HTP to boost serotonin levels
So far as the whey and BCAA, let me address them in reverse order. It is conceivable that the BCAA (which I personally think is useless if protein intake is sufficient) could be having an issue for the reasons discussed in the article on depression. BCAA compete with tryptophan for uptake into the brain since they share the same transporter; if BCAA are chronically elevated, this might further lower serotonin in addition to the low-carbohydrate intake. Whey has the highest BCAA content of any dietary protein and the same might occur. That said, both BCAA and whey raise insulin and, as discussed in the depression article, that works to lower blood BCAA content. So I suspect that it’s primarily the low-carbohydrates at work here. Raise them and I think the problem will go away.
Damn, I did it, that actually was pretty short.