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Social anxiety can be debilitating. It can feel like there is always some fear inducing event around the corner - the next book report, the next having to read out loud in class, the next presentation to colleagues, the next, “Let’s go around the room and introduce ourselves and tell why we are here,” and for some, the next ordering at a restaurant. Social anxiety can impact the choices one makes about life - guide people away from careers that align with their gifts, have them forgo activities where they may have developed life long connections, or keep them from saying hello to someone they’d love to get to know. In this reel, I discuss a common nutrient imbalance that I see in those with social anxiety and how this is addressed in treatment.
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Hypermobility—having joints that bend further than normal—is a surprisingly common trait in those with brain symptoms. RCCX is a gene module (a cluster of four genes that are inherited together). Normally, our genes are not inherited together like this. This is a big deal because three of the genes are powerhouses when it comes to our health. (1) TNXB - variants can cause hyper-mobility (from none to Ehlers Danlos). Our connective tissue isn’t just about our joints, its also about the things like permeability of our gut blood barrier and blood brain barrier, and even how vulnerable we are to upper cervical instability (which can put tension on the vagus nerve) (2) CYP21A2 - (the most important of the three when it comes to psychiatric conditions) codes for an enzyme, 21-hydroxylase - a pivotal enzyme in hormonal pathways. When this enzyme is impaired (due to a mutation), there can be problems keeping up with the demands for cortisol, resulting in mast cell activation and secondary brain inflammation. (3) C4 - codes for complement C4 - a protein involved in the immune response (and autoimmunity) TNXB and CYP21A2 have high rate of mutations. According to Dr. Sharron Meglathery’s RCCX theory - this cluster of genes appears to be at the foundation of many psychiatric conditions and complex chronic health conditions, such as mast cell activation syndrome (MCAS), chronic fatigue syndrome, chronic inflammatory response syndrome (CIRS), and postural orthostatic tachycardia syndrome (POTS). There are also common traits that appear related CYP21A2, fitting with HSP/Highly Sensitive Person. This is likely due to hormonal affects on the brain (especially the amygdala) in utero, . Symptoms and traits also align with pyrrole disorder. Interestingly, CYP21A2 contains a pyrrole structure. It is well known that early trauma and attachment disruption increase the likelihood of psychiatric and other chronic health conditions throughout the lifespan. Much of this relates to the chronic and persistent stress response that can occur when someone’s need for safety hasen’t been met while their neurophysiological pathways were being laid. In this reel, I discuss some of the biochemical “downstream” effects of this chronic high stress response. The good news is that we have tools, including targeted nutrient protocols, to address these imbalances. This can make it much easier for someone to regain or even learn for the first time what it means to feel safe. I also share my experience using nutrient protocols in children with severe early trauma and attachment disruption.
Mental Health Conditions With Strong Associations With Specific Nutrient Imbalances
It is becoming increasingly clear that optimal brain health depends on balanced nutrient levels. But how exactly do nutrients influence neurotransmitter activity? It might seem intuitive to assume that specific nutrient levels would directly lead to specific symptoms or diagnoses. However, what clinical data more often reveals are biotypes—patterns in which a single condition is associated with a small group of nutrient imbalances. For example, depression biotypes identified by the Walsh Research Institute include undermethylation, overmethylation, pyrrole disorder, copper overload, and metal toxicity. Conversely, a single nutrient imbalance can manifest in a wide range of psychiatric symptoms. Copper overload, for instance, may contribute to ADHD in one individual, while in another it may be linked to panic, insomnia, or even rage and behavioral dysregulation. That said, certain mental health conditions do show strong correlations with specific nutrient imbalances. In this article, I will cover:
The data referenced here is based on findings from the Walsh Research Institute. In my experience as a holistic child and adult psychiatrist, I consider a number of factors when evaluating and treating brain related symptoms including genetic vulnerability, attachment experience, trauma, nutrient imbalances that impact neurotransmitter functioning, “oxidative stress,” toxicity, gut microbiome issues and other sources of inflammation, hormonal imbalances, and even structural issues of the head and neck. One root cause isn’t associated with one symptom or condition. Despite this, there are certain nutrient imbalances that occur so commonly in certain psychiatric conditions that they can almost be predicted . In this reel, I discuss those conditions. Those of us trained through the Walsh Research Institute, assess for these imbalances using lab testing (along with looking at symptoms and traits) and then treat using use specific nutrient protocols. 
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The "Seat of the Soul," Our "Dreaming Neurotransmitter, Melatonin Synthesis, Relationship Between Cortisol & Melatonin, Brain Waves & Sleep Cycles.
There is a wealth of information about sleep. In this newsletter, I'll highlight aspects I find especially interesting and significant.
In a future newsletter, I will delve into tools and techniques for optimizing sleep. 
From the Walsh Research Institute’s original data.
By Courtney Snyder, MD
A Conversation About High Copper, Low Zinc, Pyrrole Disorder & Methylation Imbalances - Symptoms, Traits, Testing & Treatment I recently had the pleasure of joining Annika Taylor, a holistic health practitioner, on the Nourished By Nature: Mind Body Wellness Podcast. After sharing my journey into holistic psychiatry and defining what it means, Annika and I explored the following topics:
We also discussed a recent finding by Dr. Walsh that undermethylation is on the rise in the population, while overmethylation appears to be decreasing. Related Resources: Annika Taylor - nourishedbynature.com Walsh Research Institute For links to specific topics address see links in the description above.
In this video and podcast episode, I dive into pyrrole disorder, a common nutrient imbalance linked to various brain-related conditions affecting both adults and children. Elevated levels of Hydroxyhemopyrrolin-2-one (HPL) in the urine, often referred to as “pyrroles,” have been connected to conditions such as depression, anxiety, schizophrenia, bipolar disorder, autism, ADHD, learning disorders, substance use disorders, and even violent behavior.
In this discussion, I cover:
This episode is essential for understanding the role pyrrole disorder plays in mental health and how addressing it can lead to significant improvements in well-being. Related Resources
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Medical Disclaimer: This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having.
The sun making an “i” with the lake during my afternoon walk.
By Courtney Snyder, MD
How Viewing Schizophrenia as a Single Condition Limits the Development and Recognition of Effective Treatments. “If things are not so good, you maybe want to imagine something better." John Forbes Nash, Jr. Many know John Nash, Jr. as the brilliant mathematician portrayed by Russell Crowe in the movie "A Beautiful Mind." While the film doesn’t stay true to Nash’s real story, it does effectively depict his descent into psychosis and severe chronic mental illness.
Schizophrenia affects 1 in 300 people, or about 24 million people worldwide (2.6 million in the U.S.), and remains the most treatment-resistant psychiatric condition.
In this newsletter, using Nash's story as a reference, I will discuss:
Most people with schizophrenia are not brilliant mathematicians or Nobel Laureates; many are homeless. I reference Nash's story because it is widely known and because he likely had the most common form of schizophrenia--undermethylation (shared by 70% of those with this condition). Here are my 10 insights on schizophrenia.  "Light Showers on Tidy Town" paper, acrylic on 24 x 48" canvas "Inspired by the coastal towns of Ireland." By Courtney Snyder
One of the challenges of writing blog posts that explore root causes of brain related symptoms is that what we are learning is constantly evolving. There's so much we still and will never know. Another challenge - everything is interconnected. The best I can do is to write about these root causes separately. While some contributing factors can occur in parallel, one condition is often leading to other downstream conditions that themselves contribute to things like depressed mood, anxiety, mood swings, brain fog/inattention and so forth. Mold toxicity is a perfect example. It can contribute to Pyrrole Disorder due the stress it puts on the body. It can lead to elevated copper by overwhelming one of the antioxidants in the body that regulates copper. Because it interferes with the immune system, it can lead to a susceptibility to candida/yeast, Lyme and its co-infections. It also frequently worsens mast cell activation (see last post). I consider it a root of the roots. In my daily work, I find mold toxicity to be very common. Here’s why - Lunch with Dr. William Walsh - His Story, Discoveries & the Future of Nutrient-Based Psychiatry7/1/2016 
Courtney Snyder, MD
I first met Dr. Walsh in the fall of 2014, at his second physician training course here in the US. At the time, I was uncertain how useful nutrients would be in my psychiatric practice. What I learned seemed too good to be true. Upon returning home, I gradually began evaluating and treating specific nutrient imbalances in adults and children with depression, ADHD, anxiety, bipolar disorder, autism and other conditions. To my repeated surprise, most patients - children and adults alike improved… significantly - some dramatically, including those whose symptoms had failed to respond to other treatments. 
By Courtney Snyder, MD
Historically we've considered mental health and illness as coming from either one's life experiences or coming from one's genetics or biology. We've mistakenly considered the the brain separate from the rest of the body. We are more interconnected than those outdated views suggest. Our physical health impacts our brain health. Likewise, we experience emotions (fear, anger, sadness, and joy) not only in our brains, but in our bodies. Emotions influence our brain's biochemistry, and our biochemistry impacts our emotions, bodies and how we experience our lives. PYRROLE DISORDER A perfect example of this is Pyrrole Disorder - an inborn error of pyrrole chemistry. Those who are affected make an excessive amount of this metabolite. Pyrroles themselves are not a problem and do not cause disease. We all have them. They do however, bind Vitamin B6 and Zinc. When pyrroles leave the body (through urine), they take some B6 and zinc with them. This is not a problem either. The problem comes when pyrroles are being overproduced for genetic reasons or because of physical or emotional stress. This can lead to severe B6 and zinc deficiencies. |
Courtney Snyder, MDFor anyone experiencing brain symptoms. This blog (and weekly newsletter) is your guide to demystifying root causes and learning about surprising paths to healing. From a holistic - functional adult and child psychiatrist dedicated to helping people heal and thrive. Categories
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