Thread: Gut health/serotonin/psych issues/prescription meds correlation?

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    Gut health/serotonin/psych issues/prescription meds correlation? 
    Since I've been dealing with anxiety/depression most of my life, at my crisis points I tend to start googling new treatments/supplements/etc. Seven years ago I decided to take a route of that including acupuncture, supplements (can't remember all of them), Reiki, etc. Nothing worked, including trying many different anti-depressants. After almost two years, I agreed to ECT and it worked. I was more engaged in life than I had been in years... until nine months later I was diagnosed with cancer, and in the ensuing years, there have been more crises out of my control to the point where I'm almost pre-ECT state again. I was also given ketamine before my first two ECT treatments (this was at a teaching hospital), so who knows what was working. The docs said Pamelor (nortriptyline) seemed to be efficacious with ECT, so I was started on a low dose, along with 7.5 mg. mirtazapine to help with sleep. The one time I had a blood draw, my Pamelor wasn't even within therapeutic range, but I was doing so well, we didn't increase it, and I've stayed there since then.

    We just relocated across the country from the midwest to SoCal and I am researching new physicians. I do remember seven years ago there being some information out there about how gut health is the key to mental health because so much of our serotonin is located in the GI tract. I have had GERD for probably 20 years, eventually landing on 40mg. of Nexium in the AM and PM. I occasionally still have breakthrough symptoms if I'm not careful, meaning I eat something too close to bedtime, particularly if it's rich. And by too close to bedtime, I mean within four hours; I rarely eat anything past 7PM; if I do, I have to go to sleep sitting up.

    So I had a meet and greet with a new internist yesterday who is grounded in western medicine, but is starting to educate himself more in functional medicine. I am still having issues with my GI system (loose stools several times a week) that started when I went to a rehab for PTSD, and they weaned me off a low dose of Xanax by doing a Librium taper in 2.5 weeks. A week into it, I developed diarrhea, and in fact, it was so bad I landed in the ER dehydrated and low in my electrolytes (also... my monocyte count indicated there was some sort of inflammatory response going on inside... whether it is the gut or not, we don't know). Because the rehab did not to my satisfaction deal with the diarrhea, I checked out 2.5 weeks early so I could get home and see my own doctors; I was completely off the Librium for a week at that point. GI issues were not the only symptoms I was dealing with, so when H came to pick me up, I asked him to bring me some Xanax, and I have been back on it, under my psychiatrist's direction since leaving. The GI issues improved, but are not completely gone. So when I met with this new internist yesterday and told him what happened, he inferred that, going way back many years when I first started having GERD symptoms, we could probably speculate that, had my gut health been approached from a different standpoint, I might not have developed the GERD and become dependent on the PPIs. So I'm trying to learn more about how gut health impacts some psychiatric conditions. I did learn that 90% of our serotonin is located in our GI tract. I can only speculate if I've been taking PPIs for at least fifteen years how it 'could' do something to mess with my serotonin. I think the other variable to this equation is the food we eat. The physician I interviewed yesterday seemed to indicate he would do nothing drastic right away if I sign on with him (he's a concierge physician), but start to try to put some puzzle pieces together. I know there are so many snake-oil salesman out there that swear their 'treatment' is the one that will impact the gut, which will then help with depression/anxiety, etc. I typically stay away from gluten, only because it's typically empty calories, but since the diarrhea started, and I've lost weight (10 lbs. since admission to the rehab), I have been eating whatever appeals to me to slow the weight loss down. I'm guessing the first things someone on here who knows about this stuff (or a functional GI doc, or functional psychiatrist) is going to tell me to eliminate is grains and dairy. Someone mentioned the book, The Grain Brain, but I'm afraid if I started reading it, I'll get even less nutrition. As it stands right now, I'm avoiding nuts and fruits (was told by the nurse practitioner at the rehab that those would be the hardest on my GI system), so that eliminates a lot of what I snack on.

    Anyone here do extensive research on gut health as it relates to mental health and medications? My husband has worked in big pharma for his entire life as a researcher, and if I bring him any information that hasn't been published in a peer-reviewed journal, he will question it (actually, I would, too, after going down this road the first time seven years ago). I'm hoping in seven years there might have been more proven and acceptable research linking the two. If I truly want to eventually get off of the Xanax, I need to so something, and is that 'something' a major overhaul of my diet? FWIW... I am very physically sensitive to processed sugars (some people call it one of the most addictive drugs there is) - experience real highs and lows when it drops after I eat sugary foods, so that makes me think there might be more going on with me. In all my years of physicals, I've always had really healthy glucose numbers, though.
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