Urge, Drug, and Supplement Free!

The following is a compelling story from one of our clients:

“I was diagnosed with trich in 1^st grade and I’ve pulled every 1-3 days since then. By the time I found Dr. Oler I was 17 years old and had pulled out all my eyebrows, eyelashes and about 50% of the hair on my head. My dad’s a doctor, so I’ve tried pretty much every possible medical treatment and drug for trich out there. They didn’t help me get rid of the urge and I usually felt awful when I took them.

Within a month of starting the amino acid therapy my urge to pull was completely gone! It was great! And unbelievable! Dr. Oler told me to continue my current dosing for 2 months and follow up. Over those 2 months, I pulled a couple times, but it wasn’t an urge; it felt more like the hairs weren’t growing right and I just pulled those and left everything else alone. My eyelashes, eyebrows and hair on my head all started growing back. During this time, I stopped taking the amino acids a couple times, but noticed the urge to pull increased, so I went back to Dr. Oler’s recommendations.

After 2 more months, all my hair was grown back and I wasn’t having any urges anymore. However, I forgot to take my supplements with me when I went away from Christmas and New Years and the urges came back BIG TIME and I pulled everything out again in about 5 days. As soon as I got home, I started the supplements again and didn’t have any urge to pull after about 5 days.

I continued at this dose for 6 months. I wasn’t pulling, my energy levels were great, I slept well, my cravings were gone and I started playing rugby again. I also noticed that my focus, concentration and memory had improved and I was doing better in my classes. I was very content.

After a couple more months, Dr. Oler recommended that we start to decrease the amino acids, as by this time, my neurotransmitter stores should be back to where they belong. I was apprehensive, but reassured that I could always go back to taking what I was currently taking and get the same results within a few days even if the urge to pull returned. I had a little bit of an increased urge to pull after changing the dose, but it only lasted a few days and it wasn’t too bad, but no urges after that.

We continued to decrease the amino acid dosing over time, adjusting as needed if I had an increased urge to pull or stress triggered me to pull. I also started learning some other ways to manage stress, like deep breathing, taking a quick walk around the block and aerobic exercise which helped.

It’s now been two years since I started working with Dr. Oler and I (1) don’t have any urges to pull, (2) am no longer taking medications for trich, and (3) haven’t taken any of the amino acid supplements for over 3 months. All my hair is grown back and I have absolutely no urge to pull anymore unless there is a lot of stress in my life. Even then, I can get through it without pulling very much. I am very content where I am at. Thank you for helping me beat trich!”

-Stephanie, 08/02/11

Image: Graeme Weatherston / FreeDigitalPhotos.net

Trich – Two Kinds of Pulling

We spend a lot of time on this blog talking about the ins and outs of amino acid therapy as an effective solution to the underlying neurotransmitter imbalance(s) that often lead to trich. However, there is also a behavioral component that cannot be overlooked and must also be addressed. Most people experience both the ‘urge’ to pull and develop a ‘habit’ of pulling.

For instance, many people pull at certain times of day or under certain situations, such as while driving, while studying or when watching TV. They may not even notice that they are doing it. The key is what happens when they do notice – can they tell themselves to stop and move on without giving it another thought? Or do they then have to constantly think about it in an internal struggle not to begin pulling again?

When the underlying neurotransmitter imbalances have been addressed, the urge to pull disappears. However, the habit remains. The good news is that once the urge is gone, when a person catches themselves pulling, they can take a look at the situation and make a decision to stop pulling – and then let it go. Because the urge is gone, they no longer need to bother with any thought of pulling. If they catch themselves pulling again out of habit, they simply correct the behavior. This is in stark contrast to someone that has to continually battle with themselves to not pull their hair out.

Once the urge is gone, behavior modification therapies often are an incredible help. These can be as simple as sitting on ones hands or keeping the hands busy to help break those habitual patterns, or involve more in-depth therapy, such as cognitive behavior therapy (CBT). Many of our clients who had tried CBT in the past with little success report outstanding results once their neurotransmitter levels are balanced.

Differentiating between the urge and habit is important. Habits can be changed with time and attention. Urges require that the underlying biochemical imbalance be corrected.

To find a Cognitive Behavioral Therapist, visit the National Association of Cognitive-Behavioral Therapists website or the Trichotillomania Learning Centers Resource page.

Resources For Those With Trichotillomania

I was asked by a recent client about what resources were available for those that wanted to find out more about trichotillomania. The woman sitting across from me was bewildered with all the information on the internet in regards to trich and wanted my help to try and sort through it. Here are some great places to get you started if you need a reference point to learn more about trich, if you or someone you love has the disorder and what you can do about it.

General Information

WebMD: http://www.webmd.com/anxiety-panic/guide/trichotillomania

Trichotillomania Learning Center: http://www.trich.org/

Tests for Trich

http://www.pamguide.com.au/anxiety/ttm_test.php – provides an easy self-test

http://www.ocdla.com/trichotillomania-hair-pulling-test.html – provides a more in-depth questionnaire, but you have to send your information out to get results from them

Treatments/Therapies for Trich

Neurotransmitter Function: http://www.neuroassist.com/trichotillomania-treatments.htm and http://stoppullinghairout.com/blog/

Cognitive Behavioral Therapy: http://www.trich.org/treatment/options-cognitive.html

Amino Acid Therapy and Safety

The following is a side effect profile developed from approximately 50 patient-years of data based treatment in hand at NeuroResearch Clinics, Inc. The following results were obtained from patients taking only amino acids with no prescription drugs:

Dry mouth —- 34 (2.1%)
Insomnia —— 14 (0.9%)
Headache —– 12 (0.7%)
Nausea ——– 10 (0.6%)
Dizziness ——- 6 (0.4%)
Constipation — 6 (0.4%)

All other side effects were reported at a rate of less than 1 in 500 visits (0.02%). No irreversible side effects were noted.

Amino acid precursors are safe to administer with any prescription drug, but amino acid precursors can also cause the side effects of the prescription drugs to be displayed. Any side effect associated with the drug can be triggered.  When drug side effects occur, it is necessary to manage the situation by working with your prescribing physician to help reduce the unwanted side effects; this generally entails decreasing or stopping the drug not the amino acid.

With regards to pregnancy there is nothing in the literature indicating that the amino acid precursors are a problem. Nor is there anything in the literature indicating studies have been performed indicating they are safe. In this light it is recommended that amino acid precursors not be used in the first trimester of pregnancy, although no studies indicate this is harmful to the mother or the fetus.

Trichotillomania and Stress

Here is a story that sounds so familiar that I wanted to share it:
Trichotillomania Story

In it, Michelle explains that her pulling started after a severe amount of stress and that she often pulls more when she is stressed out. This is very, very common as stress is one of the key reasons neurotransmitter imbalances develop (see our latest post on 2 Major Causes of Neurotransmitter Imbalance).

Even though you can rebalance your neurotransmitter levels through proper amino acid therapy, properly addressing chronic stress involves a lot more than taking pills. As Michelle points out, she feels she could deal with this much better with a strong support network; this is, in fact, exactly what we have found in our clinic as well. Luckily, that support network can be made up of not only people you can see day-to-day, but also those who you can interact with via social networks and online forums. The key is to feel and be connected – to others and often to whatever higher power you believe in.

Outside of staying connected and feeling supported, many people need to implement specific daily strategies to help them management stress. This may include psychotherapy, EMDR, meditation, yoga, deep breathing, exercise and any number of other daily or regular therapies to help them lessen the impact stress has on their lives.

It may not seem easy, but getting the pieces in place certainly raises the potential for eliminating the urge to pull. Once more, it also sets the stage for long term health and healing on many levels.

How do you rebalance neurotransmitter levels: Properly balanced amino acid therapy- Part One

It is not possible to design a diet where a person can obtain enough amino acids to significantly increase neurotransmitter levels over time. This is because the uptake of amino acids by the body is not selective: foods contain an array of amino acids and no food contains just the precursors needed to specifically affect serotonin or dopamine. Therefore, when you eat food, your body takes up many different amino acids, making it impossible to target just the neurotransmitters we are trying to affect. That is where supplementation can play a vital role.

Amino acid precursors of serotonin and dopamine have two primary applications. First, proper use of amino acid precursors will keep drugs that work with neurotransmitters from depleting neurotransmitters, thus allowing the drugs to keep functioning and functioning optimally. Second, proper use of amino acids can also serve as a stand alone method to manage disorders related to neurotransmitter imbalance.

Cofactors needed

The generic protocol developed for treatment of neurotransmitter dysfunction disease relating to the catecholamine system and/or serotonin system involves the use of tyrosine, 5-HTP, cysteine and cofactors, including vitamin C, vitamin B6, calcium, selenium and folic acid. Results do not appear to be dependent on taking the amino acids with or without food; however, taking amino acids on an empty stomach should improve absorption and uptake and is therefore preferred.

In our next post we will discuss this in greater detail, and specifically focus on cysteine, selenium, and folic acid.

Amino Acid Therapy and How It Relates To Trichotillomania

We have covered a lot about the science of amino acid therapy and how it relates to trichotillomania.  Here is the next in a series of posts:

Monoamine Neurotransmitter Synthesis from Amino Acids

Figure 3: The synthesis of serotonin, dopamine, norepinephrine, and epinephrine from amino acid precursors.

The synthesis of serotonin and the catecholamines (i.e., dopamine, norepinephrine, and epinephrine) is illustrated in Figure 3. Note that the same enzyme catalyzes the conversion of 5-HTP-to-serotonin and L-dopa-to-dopamine everywhere in the body. The implications of this fact are profound.¹⁰ The administration of only 5-HTP or L-dopa will compete with and inhibit the synthesis of the opposite precursor (dopamine and serotonin respectively) at the enzyme. This means that if you take only 5-HTP (serotonin system) or only L-dopa (dopamine system) you will decrease the synthesis of the other system (dopamine or serotonin respectively).⁵⁷. This is why it is so important to have properly balanced amino acids when you are attempting to increase neurotransmitter levels. If you take only one amino acid precursor, the administered amino acid precursor will dominate the enzyme and compromise proper synthesis of the other system’s neurotransmitters, creating further imbalance.

Amino Acids and Neurotransmitter Metabolism

In the same manner, the same two enzymes –  Monoamine Oxidase (MAO) and Catecholamine-O-Methyl Transferase (COMT) – metabolize both serotonin and the catecholamines (i.e., dopamine, norepinephrine and epinephrine).The implications are equally profound.  When neurotransmitter levels are increased, enzymatic activity also increases.^{14,23, 24, 25, 26} That means that the levels of these two enzyme systems are not static; they fluctuate in response to changing neurotransmitter levels.

If you administer L-dopa or 5-HTP, the activity of MAO and COMT increases due to the increase in dopamine or serotonin levels respectively. The problem is that when L-dopa is administered without 5-HTP, both dopamine and serotonin will be subjected to increases in metabolism by these two enzyme systems. However, serotonin will not experience an increase in production (because none was taken), which leads to further depletion. The same rule is true of 5-HTP administered without the use of dopamine precursors. The bottom line is that the administration of 5-HTP or L-dopa that is unopposed or improperly balanced with the amino acid precursors of the other system will deplete the other system as a result of the increased metabolism of MAO and COMT, decreased synthesis, and uptake competition.

This means that a person has to take these amino acids in the proper balance to obtain long-term balance in neurotransmitter levels. This is complicated further due to uptake competition, which we will cover in future blog posts.

14. 5-HT immunoreactive hypothalamic neurons in rat and cat after 5-HTP administration. Brain Res Bull. 1984 Jun;12(6):721-33. Sakumoto T, Sakai K, Jouvet M, Kimura H, Maeda T.

23. Platelet MAO-B Activity and Serotonin Content in Patients with Dementia: Effect of Age, Medication, and Disease Neurochemical Research June, 1998: 863-868 Zsuzsa Meszaros, Dora Borcsiczky, Monika Mate, Jozsef Tarcali, Tamas Szombathy, Kornelia Tekes and Kalman Magyar.

24. Effect of L-dopa administration on islet monoamine oxidase activity and glucose induced insulin release in the mouse. Pancreas. 1991 Sep; 6(5): 522-7 Lundquist, I : Panagiotidis, G : Stenstrom, A.

25. Monoamine metabolism in human brain. Arch Gen Psychiatry. 1977 Jan;34(1):89- 92. Robinson DS, Sourkes TL, Nies A, Harris LS, Spector S, Bartlett DL, Kaye IS.

26. Catechol-O-Methyltransferase Inhibition Improves Set-Shifting Performance and Elevates Stimulated Dopamine Release in the Rat Prefrontal Cortex Journal of Neuroscience, June 9, 2004, 24(23):5331-5335 E. M. Tunbridge, D. M. Bannerman, T. Sharp, and P. J. Harrison.

Better Sleep and No Compulsion to Pull!

I just got off the phone with another client that has had fantastic results using amino acid therapy to address her trichotillomania. This client’s experience provides a great illustration of the far reaching effects of neurotransmitter imbalances and how quickly a person can find relief once they are rebalanced.

First, some background. This is a woman in her mid-40s, we’ll call her Tracie; she had pulled off and on for many years, but started pulling uncontrollably in 2004 when she was finally diagnosed with trichotillomania. However, she had a number of prior imbalances that most likely led to, or at least exacerbated the neurotransmitter imbalances that led to the compulsive urge to pull.  Tracie was diagnosed with depression in the mid-80s and started medication to address it. About 10 years later, she was diagnosed with major depression and fibromyalgia syndrome (FMS) and put on more medications. She was also experiencing extreme pain, diagnosed with arthritis and given heavy doses of pain killers. Finally, just last year, she was diagnosed with Crohn’s disease. Just today Tracie confided in me that she has experienced gastrointestinal (GI) distress since she was a child. She also mentioned that she was a very restless sleeper and never slept through the night or felt rested.

The reason all this matters is that every one of these conditions and treatments has an adverse effect on neurotransmitter levels. Most people know that depression is thought to be due to imbalances with a neurotransmitter called serotonin. What most people don’t know is that the medications used to treat depression actually make the underlying neurotransmitter imbalances worse over time. This makes it nearly impossible for people taking these medications to get off of them and they may feel worse and worse – unless they begin a program using amino acid therapy to address the underlying neurotransmitter imbalances.

Once more, FMS and pain are also related to neurotransmission. In our clinic, we have seen remarkable remissions of FMS and dramatically increased pain tolerance and reductions in perceived pain with properly balanced amino acid therapy. It has been shown in the literature that chronic pain often induces depression; this is due, at least in part, to the neurotransmitter imbalances that occur due to chronic pain, which then lower the pain tolerance, exacerbating pain, thus creating a vicious cycle pain inducing more pain.

Furthermore, chronic gastrointestinal disorders often cause neurotransmitter imbalance. This is thought to be for two reasons: 1) malabsorption of nutrients and 2) exaggerated loss of serotonin due to inflammation of the GI tract. The GI tract is where about 90-95% of the body’s serotonin is stored. Chronic GI distress can cause the body to ‘dump’ these stores, creating imbalance; GI imbalances can also be caused by neurotransmitter imbalances. In particular, recent research is suggesting that Crohn’s disease may be due to serotonin toxicity due to defects in neurotransmitter transporters in the gut. What’s exciting about this is that clinical experience also shows that reestablishing proper neurotransmitter imbalance using amino acid therapy can cause a complete remission of the symptoms of Crohn’s disease.

Lastly, one of the latter stages of neurotransmitter imbalance is sleep disturbance and insomnia. The sleep cycle is regulated by melatonin. This compound is created from serotonin, a process which is regulated by another neurotransmitter called norepinephrine. Again, you can see that imbalances in these neurotransmitters will lead to sleep issues over time.

So what did Tracie experience? Well, she had quite a bit of nausea when she first started on the amino acids. This is very common in people when their serotonin levels are very low. This is because the gut is so depleted of serotonin that it converts the amino acids into neurotransmitters right there in the gut rather than putting them into the circulation where they can reach the brain, which creates the experience of nausea. The solution – go slower. So, we adjusted her dosages to allow her body the time it needed to absorb and utilize the amino acids properly.

The result: as soon as Tracie got up to the original recommended starting dosage, she noticed she was much less restless while sleeping and that she actually slept through the night a few times. Her husband also noticed, as he too was now able to sleep through the nightJ. And what about the trich? Tracie stated that after about 2-3 days on the recommended dosage she had absolutely no compulsion to pull, although she did catch herself pulling a few times out of habit. However, unlike before, she could now catch herself and stop pulling and not think about it (or obsess over it) again.

What can we learn from Tracie’s story – lots of bodily and mental functions are impacted by neurotransmitter balance. However, the solution is quite simple: reestablish proper balance. Tracie did it and has eliminated the compulsion to pull with the ‘side benefit’ of better sleep. She’s so happy that we are now going to work on her other health imbalances to reestablish optimal health and function.

Tracie’s story is not uncommon – reestablishing proper neurotransmitter balance can cause dramatic positive changes in your life, and quick. We have helped 1000s of people regain their health and their lives using amino acid therapy and we’d love the opportunity to help you.

Neurotransmitter Imbalances Often Cause Trichotillomania

Imbalances in Neurotransmitters Often Cause Trichotillomania

We have a novel approach to help those with trichotillomania eliminate the urge to pull which allows them to stop pulling their hair out.  It is based on underlying biochemical imbalances in brain chemistry, and it works.

Here we begin a multiple part series describing the science and research behind this approach.  This may not be great bedtime reading, but it does provide the basis behind why this approach works, and explains why most other treatments fall short.

Like so many other disorders, including depression, anxiety, insomnia, fibromyalgia, migraine headaches, ADD/ADHD, Parkinson’s Disease, restless leg syndrome and obsessive compulsive disorders, trichotillomania often results from imbalances in neurotransmitter levels.  Neurotransmitters are chemical messengers that control the flow of information (called ‘nerve impulses’) inside the nervous system.  Imbalances in neurotransmitter levels occur for many reasons and set the stage for the disorders listed above.

What causes these imbalances?

The easy answer is that there are a number of factors that can cause neurotransmitter imbalances in any given person; often times, several factors will affect one person. They include:

• Genetics
• Trauma
• Stress
• Dietary deficiency
• Toxic exposure

No matter what the cause, there are two prevailing theories in medicine as to how these imbalances occur: the monoamine theory and the bundle damage theory.  We will delve further into these in our next post.  Stay tuned…

Is Trich an Addiction?

I read a post recently that related trich to an addiction.

In the article, ‘It’s Trichy’ thought about the similarities between trich and an addiction, such as alcoholism. There are many similarities, but the most pressing is the very real chemical imbalance that is often at the core of many obsessive-compulsive and/or addictive behaviors. What is known is that imbalances in brain chemistry can create a psychological (and many times physiological) need for or to do something. Most of the research in this area has looked at the ‘pleasure-centers’ of the brain and the chemicals that affect them, including dopamine, norepinephrine and glutamate, which are all neurotransmitters.

Interestingly, we have found that by achieving proper neurotransmitter balance, we can very often reduce or eliminate the ‘urge’, whether that is to pull in the case of trichotillomania or drink in the case of alcoholism (or any other substance in the case of other drugs of abuse). In many cases, once proper neurotransmitter balance is achieved, an immediate response is achieved, often described as a ‘light-switch’ going on. In these cases, there is an immediate and complete release from the compulsive or addictive behavior.

This makes sense if you think about this in terms of brain chemistry – if neurotransmitter imbalance is the cause of the compulsive or addictive behavior, once balance is achieved, the behavior should be dramatically impacted.  Thankfully, it usually takes only weeks to months to optimize neurotransmitter levels and achieve this release from the urge, compulsion or addiction. Then, a person is in a much better position to institute behavioral therapies and support groups to help them beat the habits they have developed. Of note, once people achieve proper neurotransmitter balance, they are much better able to distinguish between the urge to pull and the habit of pulling, which goes a long way to determining what behavioral modifications can help break the habits involved.

Trichotillomania does share many common traits with addictive-type behavior, and thankfully, amino-acid therapy is often successful at addressing the underlying cause that is at the heart of these behaviors.