How To Treat Anxiety Symptoms by Treating the Gut

Hi, this is Dr. Ruscio. Did you know that many cases of anxiety can
actually be caused by your gut? Let’s discuss a systematic review that reviewed
all of the available, randomized control trials, establishing, thankfully, that treatments
for your gut can actually improve your anxiety. Now, here’s a study by Yang, et. al., published
in the Journal of General Psychiatry. And I’ll put the abstract up here on the
screen, entitled “Effects of regulating intestinal microbiota on anxiety symptoms:
a systematic review.” Again, a systematic review will often review
the available randomized control trials and summarize the findings. So this is arguably the highest level of scientific
evidence. Thankfully, what they’ve concluded—as
I’ll outline here in a moment—is that treatments for the gut can improve anxiety. Very, very thankfully. So let’s dig into some of the details. To quote, “More and more basic studies have
indicated that gut microbiota can regulate brain function through the gut-brain axis,
and dysbiosis of intestinal microbiota was related to anxiety. However, there is no specific evidence to
support treatment of anxiety by regulating intestinal microbiota.” Well, I would not agree with that, but this
is what they’re trying to rectify. So, the aim of their study: “To find evidence
supporting improvements in anxiety symptoms by regulating intestinal microbiota.” Now, intestinal microbiota is another way
of saying the world of bacteria and fungus and other like organisms in your gut. Let’s continue. “Methods.” This systematic review of randomized control
trials looked through 3,334 articles and only 21 were high-quality enough to be included
in this analysis, with a total of about 1500 patients over the 21 studies. Here’s where things get really exciting. Let’s look at the effect of the treatment
study. “14 studies chose probiotics as interventions”
and “six chose non-probiotic ways”, mostly diet. The diet most often used—although not exclusively—what
is known as the low FODMAP diet, a diet that helps to starve bacterial overgrowths, which
can be problematic, can cause gut symptoms and inflammation, and through the gut-brain
connection, can cause anxiety. Now, regarding probiotics, you’ll hear claims
that a certain special probiotic is the best for anxiety or depression. And for years now, I’ve been saying that
probiotics are not that specific. Probiotics are not like drugs that operate
on a very narrow pathway or mechanism. Rather, probiotics, in helping to heal and
rebalance the gut, can have a wide array of improvements that they lead to, because they
are oftentimes treating the underlying cause, gut imbalances of multiple symptoms. This is how we can see different probiotic
formulas show improvements in things like various skin conditions, allergic conditions,
neurologic conditions as we’re discussing here like anxiety. There’s also other evidence showing improvements
in things like depression, and the ability to fight various bacteria and fungus in the
gut and improve symptoms of IBS, gas, bloating, constipation, loose stools, and diarrhea. Thankfully, regarding the probiotics, again,
a specific special probiotic formula was not needed. Various probiotic formulas from single strain
all the way up through multiple strain probiotics all showed benefit. What that tells you is you don’t have to
be highly prescriptive or specific with the probiotic that you use, and you don’t have
to be held hostage necessarily by marketing claims that you must use only this probiotic
or that probiotic, in attempts to improve your gut-brain connection and therefore anxiety. Here’s where things get really exciting. And I’ll quote: “56% of studies could
improve anxiety symptoms.” 56, over half of the studies, whether they’re
using probiotic or diet, most namely the low FODMAP diet, showed the ability to improve
anxiety. That is huge. If you look at the outcome of many medical
interventions, a 50% response rate is pretty darn good, especially for conditions that
can be multifactorial in cause, as anxiety can. Let me now read you their conclusion, and
I quote, “We find that more than half of the studies included showed it was positive
to treat anxiety symptoms by regulation of the intestinal microbiota,” or treating
your gut. “There are two kinds of interventions (probiotic
and non-probiotic interventions)“—remember that the most often used, although not exclusive,
non-probiotic intervention was a diet known as the low FODMAP diet—”to regulate intestinal
microbiota, and it should be highlighted that the non-probiotic interventions were more
effective than the probiotic interventions.” This makes sense. It makes sense that diet should come first
before using a supplement. So, great. “More studies are needed to clarify this
conclusion since we still cannot run meta-analysis so far.” A little bit of caution there. A meta-analysis would mean that there are
many like studies that can be summarized, to give a specific numeric score of the efficacy
or effectiveness of the treatment. We’re still short of that. However, for those who are looking to an anti-anxiety
or antidepressant medication or natural therapies, it certainly seems tenable to start at least
with a reasonable trial on diet and probiotics, see if your symptoms improve, and if not,
then consider medication. And I would always do this under the guidance
of your doctor and keeping your doctor in the loop. But great news here, that those who are suffering
with anxiety have some great natural, nutritional, and supplemental options that have at least
some high-level preliminary evidence supporting their effectiveness. Now, what can you do? Well, we want to improve the health of your
gut or improve the health of your intestinal microbiota. There are really three things I’d recommend
here specifically, in light of both my clinical experience and what this study has found. One, improve your diet. You don’t necessarily have to go to the
low FODMAP diet right out of the gate. That’s a little bit more of a specialty
diet. If you haven’t gotten sodas, sweeteners,
sugars, and processed foods out of your diet, of course, start there. Focus on cooking all of your own food and
consuming whole, fresh foods. Nothing pre-packaged, nothing processed. Buying meat, vegetables, fruit, fish, eggs. Start there. If you’re already doing that, then you can
go to a trial on the low FODMAP diet. I will put our low FODMAP diet up here on
the screen and also link to it. I believe this to be one of the most up-to-date
low FODMAP diets available, because we do follow the research literature here closely
and update continuously our low FODMAP diet as new evidence becomes available regarding
the FODMAP content in various foods. So, basic dietary changes. If you’re already there, low FODMAP diet. And you only need a couple weeks to start
seeing improvements from this diet, if it will work for you. Now, if you’ve given this diet a few weeks
and you’re not noticing any movement of your symptoms, any improvement, then you can
go on a probiotic protocol. Again, the probiotics are not highly specific. However, I have found it very effective to
try a well-rounded probiotic protocol. Some people will not fully respond to just
one probiotic or one strain of probiotic because they need more of a litany of healthy probiotics. That is why I’ve developed the three-category
system which ensures that you’ll have one good probiotic formula from the three major
categories. I’ve linked you all the information here. Essentially when we look at the probiotic
research, we see that amongst all the hundreds of studies, we can organize most probiotics
into one of three categories. You want to try all three of these categories
in combination to help give your gut the broadest, healthiest probiotic stimulus possible. This can be the difference between success
and failure for some people. You also want to make sure that you’re using
a quality probiotic. Of course, some companies will cut corners
and not put very much bacteria in there. They’ll put a lot of filler in there to
be able to have a very cheap probiotic, however you’re getting what you pay for. That’s also not to say that the most expensive
probiotic is the best. There is a balance here to be struck, and
I think we’ve really achieved that in the three-category probiotic protocol that we
recommend. In close, if you have anxiety, fortunately
there’s some very high-quality preliminary evidence showing that various treatments for
your gut—most namely a low FODMAP diet and probiotics—can be effective and improve
your anxiety. If you are suffering with anxiety, don’t
suffer another day. Take some steps to perform these simple interventions
that can not only improve your anxiety, but if you, let’s say, have constipation or
abdominal pain and anxiety, these dietary changes or probiotics could help with all
of those symptoms. When we use natural medicines that treat the
cause we oftentimes see side benefits rather than side effects, and you are positioned
to reap all the rewards of that. Again, this is Dr. Ruscio reporting in on
a very exciting systematic review on the power of the gut-brain connection and how you can
use this to improve your anxiety. I hope this information helps you get healthy
and get back to your life.

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