Anxiety deficiencies Food intolerances functional testing

Nutrition case study: Anxiety and binge eating

This case study shows how important nutrition can be in the management of anxiety.

Kate struggled with acute anxiety for at least ten years. She recalls being anxious as a child too and struggled to remember a time when she didn’t feel this way.

In her early twenties she remembered being really concerned about food and weight, she felt her concerns bordered on obsessive.

Her current anxiety meant that she struggled with getting to sleep, would wake up at night worrying about money, health, ‘anything really’. She also found contact with people difficult, having to prepare herself mentally just to make a phone call or avoiding social situations except for with very close friends.

Kate’s family history was interesting. Her mother had struggled with depression during Kate’s childhood and Kate thought that might have affected her anxiety. Her maternal grandmother had been a ‘big drinker’ and died of cirrhosis of the liver. Her maternal uncle had committed suicide many years ago. This family history, all along the maternal line, was a big clue to what might have been going on with Kate. It’s so easy to assume that social-environmental factors are what affect our mental wellness, ie growing up with a depressed parent, but what if there is a biochemical factor influencing mental health that may have been inherited?

We know that we can be born with low mineral status if our mother’s status during pregnancy is also low. We also know that our gut flora, which can influence mood, is largely influenced by that of our mother’s. However, this pattern of mental health issues extended beyond her mother and indicated to me the possible presence of the metabolic condition pyroluria. A condition which leads to excessive excretion of specific nutrients vital for good mental health. Over time, as levels of these nutrients decrease symptoms begin to show. It can manifest as social anxiety, addictions, alcoholism, eating disorders, depression and even suicide.

Kate’s approach to nutrition and diet was, on the whole, quite good, but at times she would battle with emotional eating. We noticed a pattern – that she was more likely to binge-eat when she had not slept well. A disrupted nights sleep will affect cortisol levels the next day and this will impact not only how much you eat but also your choice of foods. You might crave starchy and sugary foods and stimulants like coffee and alcohol.

Nutrition Programme:

Initially, we added protein to each of Kate’s meals and snacks as well as using l-theanine as a temporary crutch to help with both sleep and anxiety levels.

We ran two lab tests. A food intolerance test to find out if Kate was reacting to any specific foods. I suspected a food that she was routinely eating was provoking an adrenaline-type reaction in her body, which over time affected her blood sugar balance and sleep, as well as her anxiety and emotional eating. Kate was intolerant to dairy, this wasn’t really a surprise to her. She said she had felt that it ‘didn’t agree’ with her.

The second test we ran was based on her family history as well as her issues with anxiety. This was a test for urine kryptopyrolles to identify pyroluria. This test looks for raised levels of urine kryptopyrolles which can indicate the presence of the disorder mentioned above that can run in families. The test came back positive and this helped us to establish a nutrition programme moving forward. We began with low levels of zinc, pyridoxal-5-phosphate and some borage oil and found that even at low levels she was feeling the benefit.

Her anxiety subsided and she felt more confident in situations. Sometimes high doses of nutrients are used when people are diagnosed with pyroluria, but as zinc enters the cells, copper exits. This can cause a temporary increase in symptoms which can be uncomfortable at best and at worse unbearable. It is also important to be mindful that high doses of minerals can impact others and so regular blood tests may be needed when using larger doses.

With a dairy-free diet, additional nutrition and targeted supplementation Kate was able to feel much less anxious and mentally strong. I should also mention that it is not unusual to have zinc and B6 deficiencies and not have pyroluria and these deficiencies can impact your health in a similar way. What is specific to pyroluria is the chequered health issues throughout the wider family that suggests an inherited metabolic imbalance.

Sarah works with clients in person (Moseley/Kings Heath) or virtually. Get in touch if you would like to book an appointment. If you are interested in ordering a pyroluria or food intolerance testing you can do that via our online shop.


    Sarah is a clinical nutritionist specialising in mental wellbeing and the gut-brain connection.

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