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Can Social Anxiety Be Caused by a Nutritional Deficiency?

Stressed looking woman sitting

If you don’t get the right nutrients, your body won’t function to the best of its ability. Some general health conditions can be linked to nutritional deficiency, but it’s up for debate whether the same applies to specific mental health conditions. Some nutrition experts do claim that unique cases of social anxiety can actually be caused by a nutritional deficiency. In the condition several experts refer to as pyroluria, once the nutritional deficiency is taken care of, the social anxiety is relieved. Other experts are quick to dismiss the validity of this diagnosis.

Trudy Scott, a food-and-mood expert who said in an email that she has suffered from pyroluria, is a certified nutritionist, immediate past president of the National Association of Nutrition Professionals, and author of The Antianxiety Food Solution: How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood and End Cravings.

“The person experiences shyness, inner tension, and social anxiety,” Scott said in regard to symptoms of pyroluria. “Symptoms usually start in childhood and are made worse under stressful situations. The wonderful thing is that the symptoms can be completely alleviated with taking these supplements: zinc, vitamin B6, and evening primrose oil. People typically start to feel less anxious, less shy, and more social within a week. The important thing is that if you do have pyroluria, you do need to take the supplements always.”

Generally only zinc and Vitamin B6 are recommended for pyroluria, but “gamma-linolenic acid (GLA), found in evening primrose oil and borage oil, is also beneficial for those with pyroluria because its levels are often low, and supplementing with GLA improves zinc absorption,” she added. In her book about anxiety, mood, and food, she wrote a whole chapter about pyroluria.

“I am … very passionate about the subject because I have pyroluria myself and used to suffer terribly from social phobia and shyness, anxiety, unexplained fears, waking with a sense of doom and even panic attacks,” Scott said. “I have used the amazing healing powers of foods and nutrients to completely heal. I now help women find natural solutions for anxiety and other mood disorders.”

She has posted a questionnaire on her website for pyroluria. It includes a long list of symptoms, and if 15 or more items are checked on the list, it is likely a person has pyroluria: http://www.everywomanover29.com/blog/pyroluria-questionnaire-from-the-antianxiety-food-solution/

She said that in research studies, pyroluria is also called “the mauve factor.” “Much of what we know about pyroluria is based on the work of Humphrey Osmond, Abram Hoffer, and Carl Pfeiffer,” Scott said. “Much of the original work was done with schizophrenic patients in psychiatric hospital settings. Although pyroluria was first identified in the 1960s, the medical and mental health communities have been slow to recognize it, and many mental health practitioners and physicians remain unfamiliar with this condition.”

She said she learned about the condition mainly from reading the following books:
The Mood Cure by Julia Ross
Depression-Free Naturally by Joan Mathews-Larson
Nutrition and Mental Illness (1988) by Carl Pfeiffer

Her own book goes into the specific details and biological/chemical/genetic aspects of pyroluria. In her book, she cites research prevalence rates from Joan Mathews-Larson, the author of Depression-Free Naturally. Pyroluria is thought to exist in “11 percent of the healthy population” and “40 percent of adults with psychiatric disorders,” according to Scott’s book. For people with alcohol addiction, pyroluria is thought to have a 40% prevalence rate. However, the prevalence rates do depend on the source. In her own experience as a nutritionist, Scott said about 80% of her clients who have moderate to severe anxiety have symptoms associated with pyroluria.

She added that stress can be a major factor for what age pyroluria develops and that it is a genetic condition that seems to affect more women than men. In addition, people who have pyroluria tend to also have gluten sensitivity, especially if they also are dealing with other issues like depression, anxiety, autism, alcoholism, bipolar disorder, and schizophrenia, according to the book. People with pyroluria may also have digestive problems, and they need to make sure to balance out an increased Vitamin B intake with a higher intake of magnesium.

In the book The Mood Cure by Julia Ross, the author includes a discussion of the prevalence, testing, and treatment of pyroluria, as well as a checklist similar to that offered by Trudy Scott. Ross states that the questionnaire was developed by Dr. Carl Pfeiffer, a clinician and researcher. He wrote the book Nutrition and Mental Illness: An Orthomolecular Approach to Balancing Body Chemistry in 1988.

Ross states in her book that pyroluria is fairly uncommon in the general public, but in certain groups of people (like those who have experienced alcohol addiction), it is more common. “I am just getting familiar with this condition, but I can see that it is an important one for certain people, affecting stress levels and mood generally and preventing full response to nutrient therapy until it is addressed,” Ross wrote in her book.

There are a plethora of articles dedicated to nutrition, diet, and mental health in general, as well as multiple research studies suggesting that certain mental health issues can be improved through natural supplements and a healthy overall diet. “Notably, essential vitamins, minerals, and omega-3 fatty acids are often deficient in the general population in America and other developed countries and are exceptionally deficient in patients suffering from mental disorders,” according to an abstract from a research study in Nutrition Journal. “Studies have shown that daily supplements of vital nutrients often effectively reduce patients’ symptoms.”

Another abstract from a research article in the journal Alternative Therapies in Health and Medicine concludes the following: “Many patients will benefit from the use of specific dietary supplements, such as a multivitamin-mineral high in B vitamins and omega-3 fatty acid,” according to the abstract. “And no matter what the underlying cause of the mood disorder, patients should be counseled about the relationship between food and mood, for the evidence now substantiates what laypeople and medical professionals have long known intuitively: the way we eat affects the way we feel.”

The research, authored by Tieraona Low Dog, director of the fellowship at Arizona Center for Integrative Medicine at University of Arizona, added in the research abstract that the healthiest diet for improving mental health is a “low-glycemic, modified Mediterranean diet rich in fruits, vegetables, whole grains, and seafood (if not vegetarian) and low in processed, refined foods.”

Other experts remain unaware of the condition and are skeptical of its legitimacy. Scott Carroll, a psychiatrist with dual board certifications in adult and child and adolescent psychiatry, said in an email that he is not accustomed to pyroluria and had to look it up on Google to find out what it was.

“Once I saw that it is connected to orthomolecular psychiatry, which I have heard of, I knew it was in the pseudoscience realm,” said Carroll, who is also an assistant professor at the University of New Mexico School of Medicine. “Not surprisingly, it claims to be the cause of a number of unrelated psychiatric disorders, which is typical of pseudoscience disorders. Like so many ‘cure-alls,’ it sounds plausible, but there is no scientific basis to it, and it allows dubious practitioners to prey on desperate, suffering people.”

He said there are certain cases where nutrition can play a part in mood and mental disorders. “Inadequate amounts of Omega 3 fatty acids, especially from fish or krill oil, have been shown to affect mood and anxiety in a broad way of which social anxiety can be a part,” Carroll said. “Also, low folate, low Vitamin D, and low B12 have all been associated with negative effects on mood and anxiety.”

“However, in people with low folate, it is more often a case of a genetic inability to transport the folate molecule into the brain rather than a low blood level,” he added. “In those cases, which often present with chronic depression and anxiety that has never responded to antidepressants, there are folate precursors that are more lipophilic and can diffuse into the brain without use of a transport mechanism.”

Nerina Garcia-Arcement, a licensed clinical psychologist and clinical assistant professor at the NYU School of Medicine, said in an email that she didn’t study pyroluria in school and hasn’t read about it in any research studies after graduating from her doctorate program.

“Based on current knowledge it does not appear to be a legitimate health condition,” Garcia-Arcement said. “Further research is required to further explore and understand whether social anxiety or any other mental health condition could be related to improper synthesis in the blood.  Although this theory seems appealing, being able to ‘cure’ a mental disorder with vitamins or supplements … is unlikely.”

“Causes of social anxiety that have been substantiated by research include chemical imbalances in the brain (i.e., serotonin, a neurotransmitter), inherited traits (genetic and through observing anxious family members), negative life events or experiences, and an overactive amygdala (a part of the brain that controls emotions, including fear response),” she added.

She said that good nutrition is important for overall health, but it’s not necessarily linked to mental disorders. “In my experience, the social anxiety could be traced to other causes, not nutritional deficiencies,” Garcia-Arcement said. “Having a healthy and balanced diet is overall beneficial, but it won’t cure social anxiety or a mood disorder. I am more likely to recommend my clients get enough sun exposure to improve their moods (seasonal affective disorder) than recommend diet changes.”

Related articles:
Social Anxiety Can Be a Hidden Problem in College
Breathing Lessons
The Birth of Anxiety

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Comments
  • dorothy August 9th, 2012 at 7:07 PM #1

    its hard to believe diet can help mental health conditions but then our brain is but an organ of the body,which itself receives nutrition from diet..went through the list and thankfully I only exhibit only 3 symptoms so Im far away from the 15 symptoms mark..anyway I think they need to study this more and provide a definitive answer to people in general.its a health concern after all.

  • Ellie August 10th, 2012 at 4:20 AM #2

    I suppose that’s a pretty interesting theory but I think that in the end the final paragraph sums it all up nicely. While it is iimportant to eat healthy and to give your body proper nutrition and diet, it is kind of a stretch to think that what we eat can have any sort of control over whether or not we struggle with anxiety issues in life. There are many disorders that nutrition plays a role in, and I am fully accepting of that, but even I was skeptical when I read the title of this article. And I think that the evidence within this very article sorts that all out quite nicely.

  • Nik August 10th, 2012 at 11:07 AM #3

    There is unfortunately no easy answer to this as there are so many varying opinions on the subject. While I am not sure that a nutritional deficiency alone could contribute to a host of mental disorders, what I do know is that for me when all of my nutritional and health needs are being met and utilized, then that is when I feel the most productive and healthier overall. So while a lack of one thing or another may not cause bipolar or whatever, I do see how you could reach the conclusion that getting whole mind/body balance thing corrected could have some benefits for some patients who are willing to work on that and try to reach a healthier state of being.

  • P.U August 10th, 2012 at 1:03 PM #4

    While social anxiety directly being attributed to nutritional deficiencies does seem it is somewhat taking things too far,I am pretty sure it can be indirectly possible.

    What we eat has a big role in how we feel and other things.Those things can then go on to relate to social anxiety either directly or through one or more levels indirectly. But to completely dismiss this theory wouldn’t be right either.

  • Lisa Moore August 10th, 2012 at 5:14 PM #5

    I know that when I eliminate grains completely my anxiety increases three fold. A very low carb diet is NOT good for me or my brain. Also, when I eliminate wheat/gluten my mood greatly improves, it is like a fog lifts !

  • olive August 11th, 2012 at 4:24 AM #6

    @ Lisa- isn’t wheat a carb, therefore shouldn’t you feel worse when this is gone too?

  • Janeen August 11th, 2012 at 7:11 PM #7

    Fabulous article. It’s about time we start looking at how diet can impact mental health. If you’re not sure it does, ask a diabetic how they feel when their blood sugar is off, or heck, let’s go to the bar and have a few drinks and then test the gut-brain connection theory. Thanks for this very well-written piece.

  • Verna M August 12th, 2012 at 6:01 AM #8

    There are some things that we know and others that we don’t. I realize that many people will automatically discount the food/deficiency/anxiety relationship, but it has been proven true time and again that the foods that we eat and the nutrients that we do or do not receive from that food can play a huge role in the overall stability of our health. Aren’t we looking at the ways that food can improve autism in children and how certain diets are more benficial for others? The why not for anxiety too? I don’t think that you should discount anything before all of the evidence is in.

  • valerie August 13th, 2012 at 4:23 AM #9

    Whatever happened to sticking to the things that work and just realizing that all the rest of this is just a bunch of hooey?

  • Karen Langston Nutritionist August 14th, 2012 at 10:08 PM #10

    Thank goodness their are people like Trudy Scott out there using a functional nutritional approach to what the medical profession is not yet ready to embrace. There is a ton of research indicating food and specific nutrients can make a difference to the point that Psychologists and psychiatrists are seeing great results in alleviating depression, anxiety and other social disorders and giving patients their life back. I have learned with my own healing journey from Crohn’s disease that not only does diet and supplementation play a huge role in how I feel but changed my health for the better and gave me my life back!

  • Julia Ross August 15th, 2012 at 12:00 PM #11

    Thanks for your article on this important but little known condition. The links between nutrition and anxiety go far beyond pyroluria, as I explain in my book, THE MOOD CURE. Our clinic sees many anxious, over-stressed, and panicky clients who have much simpler nutritional needs. They respond quickly to the serotonin precursor amino acids (tryptophan or 5HTP) and/or to GABA supplementation, all readily available online or in health or drug stores.

    Pyroluria takes longer to respond. As Trudy Scott mentions, pyroluria requires additional carefully monitored mega-doses of B6, zinc, and GLA (and some other nutrients that a 4-6 per day multi-vitamin can provide.)

    As you can see from the questionnaire, treating pyroluria can be well worth the effort. Although only roughly 10% of the general population experiences this genetic condition, it is much more common among those who suffer from chronic anxiety, and the percentage seems to be going up as the U.S. diet deteriorates and the nutrient deficiencies that cause pyroluria become deeper.

  • Barbara McCollough, LICSW August 15th, 2012 at 3:20 PM #12

    Thank you for featuring this issue of food and mental health. This discussion reminds me of the old scientific proof that hummingbirds can’t fly, (“The hummingbird is an animal that by all rights shouldn’t be able to fly” (Popular Science). But not only can this bird fly, it is the only bird able to fly forwards, backward, up, down, sideways, upside down, and even hover”)

    As a traditionally trained psychotherapist with a private practice of over thirty years, I would have said some of the things the more scientifically oriented respondents in your article said. Those were the days I thought I knew everything and had the research to back me up. Then I was humbled to have my own devastating brush with unrelenting, life threatening symptoms and by good fortune that is beyond my understanding came in contact with the work of Trudy Scott. Within twenty four hours of taking the recommended zinc and B6 , the horrific symptoms of dread subsided and as I go forward with other natural food related changes such as the removal of gluten from my diet , my memory and intellectual functioning are improving daily.

    As for social anxiety, there are, as Garcia-Arcement suggests, many causes, the least of which might be the reticence one develops upon seeing their cognitive function and verbal clarity abandon them without notice. Yes, indeed, that made me avoid many parties before I discovered the simplicity of supplemental zinc and B6.

    There are many diagnoses that are now medically acceptable that used to be thought of as pseudo science. Fibromyalgia is one of them. The other day I was speaking with a very well respected Harvard trained neurologist about his own fibromyalgia. We mused over the fact that not so long ago fibromyalgia was dismissed as psychosomatic.

    So, in the end, perhaps the term “pseudo science” means we don’t know and hopefully with opened minds and hearts and further study we will learn more.

    After all, hummingbirds are out there flying around with exuberance.

  • Suelynn Hanegraaf September 13th, 2012 at 4:03 PM #13

    Symptoms of pyroluria, including social anxiety, are also symptoms of other metabolism imbalances such as zinc deficiency and under or overmethylation. A knowledgeable physician or health care practitioner would evaluate and treat these imbalances with prescribed nutrients targeted to the individual’s biochemistry. I highly recommend a newly published book, Nutrient Power, by William J. Walsh, PhD, internationally recognized expert in nutritional medicine. He describes his groundbreaking work with pioneer Dr. Carl Pfeiffer and presents a science-based nutrient therapy system to correct individuals with pyrole disorder and other biochemical imbalances.

  • Harry Roberts September 15th, 2012 at 5:06 AM #14

    It took me 8 years of searching to find out why I suffered from anxiety, depression, brain fog, chronic fatigue and digestive issues. My Pyroluria diagnosis, by a doctor who specializes in it, has been the only thing that has worked. I’m not perfect…just 20 times better than I used to be. There were stages in the 8 years I was undiagnosed where I was a completely non-functional person, now life is a whole lot easier.

  • Ashlee December 31st, 2012 at 12:52 AM #15

    A VEGETARIAN DIET IS THE WORST FOR PYROLURIA!!!!!!!!!!!!

    My pyroluria was exacerbated by vegetarianism.

  • David July 10th, 2013 at 7:47 PM #16

    Im just a regular 8-5 working, 34 year old male. I suffered from many of the symptoms of Pyroluria even as a young age. Stress is what flares Pyroluria up. By this time Im working full time and just bought my first home. It was a lot of pressure and the stress was unreal. When I was 30 I totally lost it when the stress of a child on the way was suspected. Ended up not being the case. I had to see a doctor. I was put on pill after pill and talk therapy because they thought my parents divorce and my relationship with my father was part of the problem. I never agreed with that, but I trusted the doctors advice. I finally got so fed up with the unreal anxiety and severe inner tension I just Google those symptoms. “anxiety severe inner tension”. This is when I was introduced to Pyroluria and the symptoms from severe inner tension, irrational anxiety, depression, white specks on nails, no breakfast, no dream recall, and many more were symptoms that were vague, but too many fit. I then found a doctor that understood the condition and I was fed up with just covering up my symptoms. I upped my B6, Zinc, Magnesium, and added Primrose oil. It was like a light switch went off. A year now and Im feeling great. Ive been called a conspiracy theorist, but the pharmaceutical industry is worth a quarter trillion. I gave them so much of my money to only cover my problem. They would lose too much money if this were mainstream. When I went to the doctor after I lost it. I talked for 30 minutes and walked out with 3 prescriptions. Sure they helped, but I would have to be a customer of theirs forever. This concerned me because what if I lost my job and insurance. Seroquel will break the average person. Now I just supplement my diet and eat the right foods. My main symptoms were anxiety, depression, and severe inner tension. I can actually feel relief like everything is flowing in my body. Before I was always tensed up. I had perineum pain that was unreal. Went to the ER once it was so bad during an anxiety spell. The ER doctor said there was nothing he could do. At that time I didnt know it was the perineum muscle. I just had an ache behind my testicle area. Big freak out for a guy! Then I really went digging around and found the sore area. My perineum. The ER doctor had to of touched every area but there. Even the prostate and an ultrasound! Anyhow that tension is relieved. It helped my sex life significantly. When I was tensed the blood would stop flowing to my male parts. Then with the anxiety and depression I wasnt even interested in sex. Alcohol was my only cure for that, but I didnt like to drink alcohol. But I would if I needed to for a night =). I would recommend to at least be open minded and remember there is a lot of money spent to surpress anything that takes money away from the pharmaceutical companies. And treating Pyroluria is a huge financial loss for them. I was spending $60 a month on 3 -4 prescriptions for 3 years. That was with pretty good insurance. I had Seroquel which was the highest copay at $25. That drug is evil! Good luck to everyone and remember keep an open mind. Nutrition is worth a shot over pill after pill. I do not have any major diseases. I literally felt like my problem was chemical. I just didnt feel right and I wasnt acting right. Plus too many of the symptoms fit. See I get so excited telling my story. Good luck.

  • Susun December 7th, 2013 at 8:10 AM #17

    David,

    Your story is mine… well, w/o the male problems! ;-) But the inner tension – yes!

    I was on a constantly changing cocktail of RX meds, including Susie-Q (seroquel,) Risperdal, Ativan, Ambien, various SSRIs, on&on…

    How much EPO, B6 & Zinc are you taking?

    Thank you!

  • Angie June 22nd, 2014 at 6:23 PM #18

    Anxiety can be caused by eating food that are not proper. Before I had this problem too, but now I know more about this problem, because of I eat the best food.

  • Integrated Wellness Clinic June 27th, 2014 at 12:38 AM #19

    Thank you for helping people with this information for
    more info about Pyroluria .please click the link below:
    integratedwellnessclinic.com.au/pyroluria/

  • Eliza E. October 16th, 2014 at 7:42 AM #20

    Hey! I like this article. Thanks for writing it. However, something I noticed:

    This article mentions Pyroluria and then talks about the benefit of omega 3 fatty acids for mental health. However, the Functional MD who read my tests and diagnosed me with Pyroluria said people with Pyroluria should not take fish oil because it makes things worse. But primrose oil is good for pyrolurics. I just found out the results to my test yesterday so I haven’t started a treatment protocol yet. However, I’ve read a lot about Pyroluria over the past months while trying to sort out my own mental health issues, and I’m glad to have another piece of the puzzle.

    I also read about the fish oil/primrose oil topic on this forum thread: braintalkcommunities.org/archives/06_11/showthread.php?t=1932

    And alternativementalhealth.com contains a lot of good info about Pyroluria – most of it directly from Carl Pfeiffer and William Walsh. I read a lot about methylation on this site too because I have the genetic mutation 1298 C/C homozygous and low whole blood histamine, meaning I was born as an overmethylator. This makes it important that I supplement with the active forms of the B vitamins, especially methylfolate, and do other stuff I haven’t quite figured out yet. I’ve read that Niacin is helpful for overmehtylation and I feel really calm after I take 50 mg or 100 mg of Niacin (nicotinic acid). This is just my explanation at present.. I’m still learning about all this.

    I used to be bipolar, depressed, anxious, alcoholic, bulimic, ADHD, and addicted to sugar and binge eating. This was my life for almost ten years. I tried all sorts of psych meds and it was hell. I went to the psych ward twice, but nothing they did or said or gave me really helped me. Giving up sugar was much easier for me when I started using amino acids after reading The Mood Cure by Julia Ross.

    I read The Mood Cure earlier this year and started taking amino acids. This was just the beginning, and I haven’t stopped reading about nutritional therapy and functional medicine since then. It’s absolutely changed myself and my life and my health. I don’t take any more psych meds and this year has been the first in my 27 years of life that I’ve truly experienced stability, peace, contentment, the ability to focus, bravery, connection to others, and normal living.

    I’m still working on finding the right combination of supplements, but I’m confident I will get there. I’m not aiming for perfection, just a normal life that gives me a chance to be a real person. Mainstream psychiatry and therapy did not give me this.

    For the past week I’ve been eating low-carb paleo (no sugar, caffeine, dairy, gluten, grains, alcohol, artificial sweeteners, dyes) that is mostly vegetables and grass-fed meats and eggs (all organic as much as possible). The diet has been amazing for me. My concentration and ability to read/focus/understand improved ten-fold in a matter of days. I can’t yet speak for its effectiveness long term (I’ve read a lot about low-carb diets producing great benefit at first, but then the benefit doesn’t last), but I’m going to see it through for a while. I take nutritional supplements so I haven’t really struggled with sugar cravings. There is so much controversy around foods and the ideal diet, and I get too stressed and overwhelmed to function if I spend too long researching it. Instead, it’s best for me to choose a way of eating and try it for a while and not obsess, but instead just see how I feel.

    I’ve also read that a lot of people have experienced chronic anxiety due to Candida. I am most familiar with this from the website holistichelp.net by Cynthia Perkins. I love this site because it’s comprehensive and easy to understand. I’ve had two phone consultations with Cynthia and I enjoyed talking to someone who is knowledgeable and has first-hand experience with all this stuff. She’s a holisitic health practitioner (M.Ed in Counseling, I think) but of course, she would be the first to tell you that she’s not a substitute for a (holistic) medical doctor. However it was helpful for me to have someone affordable and easily accessible that I could talk to.. especially during desperate times, when I needed to feel like I was doing something to move forward with my health. It’s about $50/$100 per phone consult and I was able to get appointments the same week I initiated contact. Functional MDs and Naturopathic Doctors are great and necessary and life-saving but holy shit, they are expensive and the waiting list is long. Cynthia is the one who recommended this low-carb Paleo (slightly modified Paleo) diet to me and her website talks a lot about it.

    Happy healing everyone!

    -Eliza

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