Anxiety with Dr. Kendra Becker: Rational Wellness Podcast 88
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Dr. Kendra Becker discusses Anxiety in Children with Dr. Ben Weitz.
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Podcast Highlights
4:02 There has been a large increase in the percentage of children and teens suffering with anxiety in the United States in the last 20 years and Dr. Becker feels that part of this is due to the implementation of the Common Core curriculum in public schools in 2007, which promotes teaching that doesn’t match where children are neuro-developmentally. In other words, they start teaching children to learn things before their brains are ready for it and they also placed too much focus on testing, including even testing kindergartners.
9:30 Social media and screen time have a role to play in increasing anxiety in children. Screen time turns off the creative center in the brain, which is especially problematic in a brain that’s underdeveloped due to being very young. Humans really don’t fully develop their brains until about age 25, so parents should limit the time kids spend in front of a screen.
13:38 Dr. Becker likes to do comprehensive lab work on her patients that includes vitamin and mineral testing, including vitamin D, vitamin A, mineral levels in red blood cells, cortisol testing, hormone testing. She will often start with serum levels of nutrients that are covered by health insurance. Dr. Becker said that she does use Great Plains lab for toxins. She also likes to test for toxins. She tries to be mindful of her patients finances and tries to use conventional labs that are covered by insurance, but she will use the Spectracell Micronutrient test or the Genova NutraEval test for some patients that require it. Dr. Becker also tests for genetics.
16:47 Toxic chemicals like heavy metals, BPA, and glyphosate can also be factors in causing anxiety in children. Anxiety results from a state of inflammation, which can result from toxins or even heavy metals like lead that competitively inhibit the body’s ability to use beneficial minerals and vitamins and this is even more problematic if the patient has certain genetic defects, like MTHFR, which can jam up your methylation pathway and result inflammation without the right nutrients.
19:17 Certain nutritional deficiencies, like vitamin B12 can cause anxiety or if there is too much B12 for that person, this can also cause anxiety. She will look at serum B12, folate, methylmalonic acid, homocysteine, ceruloplasmin, C-reactive protein and the whole methylation pathway. You also have to look for MTHFR or COMT, etc. Sometimes Dr. Becker will recommend B12 and folate, sometimes B1, and sometimes molybdenum, which helps B12 to get through the receptor more efficiently. Also molybdenum breaks down the Epstein-Barr virus.
22:35 Diet, esp. fluctuations in blood sugar levels, can affect anxiety levels in children. Dr. Becker recommends feeding your kids protein in the morning. Throw out the cereal and feed them eggs. If you front load kids with carbohydrates and sugar in the morning, they’ll peak and then they’ll tank. Her kids have eggs and vegetables like onions, peppers, spinach, etc. and also bacon. She said that her son had sausage and kale soup for breakfast this morning. Right after an athletic event, her son will often have low blood sugar, so she will give him something that has both some quick carbohydrates and a little bit of long-acting carbohydrates and a ton of protein.
26:37 Dr. Becker said that she’ll speak to the parents about gluten and dairy. Gluten is a sticky protein found in wheat and it causes leaky gut for up to three hours after consumption. And if you have leaky gut, you probably have leaky brain, since these proteins like gluten go straight to the brain and can affect the anxiety center or cause aggression in children. She highly recommends avoiding gluten, diary, corn, and soy. She generally does not order a food sensitivity panel from Cyrex or one of the other companies offering such panels due to the cost. She will sometimes order standard IgG testing for gluten, dairy, corn, and soy from standard labs, which is usually covered by insurance.
31:46 To assess gut health in children, Dr. Becker will often order the GI Effects stool test from Genova Labs and she includes the zonulin marker for leaky gut. She will then use nutritional products like antimicrobials, probiotics, gut healing combination products, chlorophyl, molybdenum which helps with acetylaldehyde, or colostrum.
34:27 Dr. Becker explained that the following nutritional supplements can help children with anxiety, depending upon the child: 1. Glycine, which binds to the same receptors that benzodiazopenes do, 2. vitamin D, which is a precursor to dopamine, 3. fish oil, 4. a probiotic.
35:27 There are some genetic factors that affect anxiety like MTHFR and COMT. COMT is like the garbage man that gets rid of the old, used up neurotransmitters. Some have a variant that makes them COMT up-regulators and they can be very sensitive to B vitamins. Everybody needs methyl B12, but if they are COMT up-regulators you need to be careful not to give them too much. Sometimes it is better not to give them B12 at all and hope that they can get their B vitamins from green vegetables. Sometimes it is better to give them B1 or B2 and avoid B6, 9, and 12. Sometimes you want to give adenosyl or hydroxy B12. If a patient has a down-regulated CIMT, you may need to support the adrenals and exercise can be very helpful for these patients.
40:09 Dr. Becker does not believe that kids should be doing any homework since it does not enhance learning. She often gives them a doctor’s note so that they do not have to do homework.
46:01 Dr. Becker finds that chiropractic is helpful for children with anxiety. When you get a chiropractic adjustment, not only are you removing interference from a spiritual level, but you’re also increasing endorphins, oxygen, and healing components of your immune system into your brain and into your nervous system. For some patients, chiropractic can be a real game-changer.
Dr. Kendra Becker is a Naturopathic Doctor who has a specialty in treating children with asthma, autism, allergies, eczema, and anxiety disorder, among other conditions. Dr. Becker teaches and lectures on various topics, including concussion, autism, MTHFR, and genetic mutations. She is also the author of two books, A Delicious Way to Heal the Gut, and All You Can Eat. Dr. Becker can be contacted at the Family Wellness Centre Of Connecticut.
Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.
Podcast Transcripts
Dr. Weitz: This is Dr. Ben Weitz with the Rational Wellness podcast bringing you the cutting edge information on health and nutrition from the latest scientific research by interviewing the top experts in the field. Please subscribe to the Rational Wellness podcast on iTunes and YouTube, and sign up for my free e-book on my website by going to drweitz.com. Let’s get started on your road to better health. Hello Rational Wellness podcasters. Thank you so much for joining me again today. For those of you who enjoy listening to the Rational Wellness podcasts, please go to iTunes and give us a ratings and reviews so more people will find out about our Rational Wellness podcast. Today our topic is anxiety in children with Dr. Kendra Becker. In the pediatric population, anxiety is a common phenomenon and it is growing fairly rapidly.
According to the National Institutes of Health website, 31.9 percent of adults in 2018 suffered with an anxiety disorder. Between 2007 and 2012 there was a 20 percent increase in diagnoses of anxiety among children ages six to seventeen. A survey of incoming freshman at UCLA found that when asked if they felt overwhelm with all they had to do in 1995, 18 percent answered yes. By 2000, that number had climbed to 28 percent. By 2016, the percentage that said yes was 41 percent. According to anxietycenter.com, anxiety is defined as a state of apprehension, uncertainty and fear resulting from anticipation of an event or situation which is perceived as being threatening, often impairing physical and psychological functioning. In other words, anxiety occurs when we behave in an apprehensive manner, such as when worrying about a non-threatening event or situation.
There are literally hundreds of symptoms that have been associated with anxiety disorder, though some of them more common include rapid heart rate, shortness of breath, excess sweating, twitching, insomnia, frequent urination or diarrhea. However in children, anxiety can be difficult to diagnose and it’s easy to mistake anxiety for a learning disorder or Attention Deficit Disorder. Anxiety in children can manifest as agitation, restlessness, inattention, poor focus, refusing to go to school, meltdowns, crying, et cetera. In reality, some children may have anxiety and ADD at the same time. Children may also experience somatic manifestations of anxiety that can include stomach pain, muscle pain, or headaches.
Our special guest today is Dr. Kendra Becker, who’s an integrated naturopathic physician with a specialty in treating children with asthma, autism, allergies, eczema, and anxiety disorder, among other conditions. Dr. Becker teaches and lectures on various topics, including concussion, autism, MTHFR, and other genetic mutations. She’s the author of two books: A Delicious Way to Heal the Gut, and All You Can Eat, which was just released in May. Dr. Becker, thank you so much for joining me.
Dr. Becker: Thank you so much for having me.
Dr. Weitz: Can you talk about some of the reasons why we have this big increase in anxiety among children?
Dr. Becker: I think it’s really like everything else with the human body; it’s multifaceted. I think, especially with the statistics that you just read, around 2007 is when they introduced Common Core, which is a different learning form in the public schools. One of the biggest shortcomings with Common Core is that the way that the curriculum was set up, it wasn’t set up to really match where children were neurodevelopmentally. They were teaching children younger than their brains were developed to be able to learn the skills that were on the roster. The other thing that they added was they started testing kindergartners. The testing wasn’t this global comprehension. It was a very concrete paper, write the answer, it’s either correct or wrong testing. They were doing things like putting up cardboard petitions between children sitting at their desks.
They were really putting a real hyper-focus on this testing. I think that in and of itself is a huge thing that really contributed to what we were seeing as far as anxiety and the epidemic numbers. In my practice it was exactly the same. I had seen maybe prior to 2007 a handful of kids with anxiety that had manifested, as you spoke about, in ADD or ADHD. But after 2007 I would say probably is about 20 percent of my practice.
It was just really interesting how it was literally like a light switch. The other thing, which is where my area of expertise is, is just to focus on the genetic predisposition. Our genetics don’t define us. I always use my 96-year-old grandmother as an example. She lived to be 96. She died with all of her teeth in her mouth. She was the same weight the day she died as she was the day she graduated from high school. She was an Italian immigrant that walked everyday and ate a bunch of green vegetables morning, noon, and night. Her genetics were terrible. They were absolutely terrible. She had all the genetic predispositions for tons and tons of inflammation: cancer, thyroid disease. None of which ever manifested in her body because of the way she took care of herself. I think that having a genetic predisposition doesn’t mean you have to own a diagnosis but in this case, certainly with the exogenous stress from our environment: schooling, stressful home life, whatever it is that predisposes that child, can certainly play a huge role in what we’re seeing as far as anxiety in little kids.
Dr. Weitz: Yeah. I could understand that test score thing. I live on the west side of L.A. and we’re talking about a big focus on kids being super successful and being able to go to really good colleges. There’s so much emphasis on test scores. Everybody’s got tutors and sending their kids to special programs for learning outside of school, on top of paying for expensive private schools. It’s amazing the amount of pressure on these kids.
Dr. Becker: I know. It’s really interesting yet the Bill Gates’ of the world don’t allow their children to have any electronic devices and send their kids to Waldorf. That always is so fascinating to me because if you know anything about Waldorf, they don’t really give children a pen and a paper to physically write until their about nine years old because that’s when the brain catches up with the fine motor. It’s just a really different learning structure. I think there’s something to be said about that. You’ve seen the schools across the country that doubled up recess or doubled up the amount of time kids have at lunchtime, and all of their test scores went up. I definitely think all of those things are a great shakeout for kids that have anxiety.
Dr. Weitz: Yeah. You wonder if all this emphasis on test scores is not the best way to be rating our schools or our teachers. Are we trying to force kids into some narrow model that’s maybe … They have this objective performance but maybe you’re creating psychological problems and maybe we’re de-emphasizing creativity, which I think is super important.
Dr. Becker: I totally agree. I think that’s a lot of what you’re seeing in children is they don’t fit into this little square box. That’s where some of the anxiety comes in. Even with the kids in my practice what I hear all the time … Here’s a really great story about a little girl with anxiety. At home, she’s a beast. The parents schedule their parent-teacher conference. They’re going in with the tissues and their going in with a rescue remedy because they’re sure that it’s going to be a horrible, horrible conference. Well what they heard from the teacher was is that kid is an angel all day long. She’s a helper, her grades are fine. Everything that she’s supposed to be doing, she’s doing. But what was happening to her is she was so stressed out for keeping it together for the six hours that she was in school that when she would come home she would literally fall apart. Her symptom picture manifested in just very, very aggressive belligerent behavior. I think she was 12 at the time, which is uncomfortable for parents that see that in their child.
Dr. Weitz: Interesting. What role do you think social media plays in this anxiety?
Dr. Becker: I don’t know. Social media I’m sure plays a huge role in it. I think screen time starts far earlier than social media. We know, just like you said, screen time turns off the creative center in the brain. When you’re turning off the creative center in a brain that’s undeveloped, and humans really don’t fully develop their brains until about 25, then you’re really only allowing for one trajectory to really develop. I think that’s definitely part of it, and then certainly social media in general. There’s a lot of pressure for us, for adults that are emotionally well-developed, on social media. Who’s putting out a course this week and who had their 20 pound weight loss transformation? And everything else. I think these are the conversations that you have to have with your kids. My kids are young. My kids are nine and 12. They get about 30 minutes a day. My son who’s nine gets about 30 minutes a day of screen time. My daughter gets a little bit more based on her behavior. For them, I think that’s enough. In fact for me, if it were up to me, I would say absolutely none whatsoever but we make our accommodations.
Dr. Weitz: Yeah. No, I can see from the parents who come in with their kids to see me for chiropractic, for years there would be books and there would be various toys. Even if they were doing something electronically a lot times it would be some educational game. Now the parents just hand the kid a phone or an iPad. They’re just …
Dr. Becker: Yeah. We do the same thing. It astounds me every time that I see a baby under two years old with a phone that knows how to use it, that can scroll through. It just is astounding to me. Astounding.
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Dr. Weitz: What are the most common symptoms you see with kids with anxiety?
Dr. Becker: Actually it manifests a lot in aggression. That’s what the patients come in the office for. You know what I mean? The other thing I see a lot is the ADHD, ADD inattentive-type behavior at school. Those are the two things that I actively treat for. I would say 90 percent of ADD or ADHD that I see in my office is generally anxiety in kids.
Dr. Weitz: Well how do you know that belligerent behavior isn’t bipolar disorder or some other psychological condition, rather than anxiety?
Dr. Becker: Because you got to tease it out, right?
Dr. Weitz: Okay.
Dr. Becker: For me, I do comprehensive lab work. I look a lot at genetics. Family history is huge with things like bipolar and schizophrenia, things like that. The other thing, years ago we would say “Oh bipolar really doesn’t take hold in a body. It’s hard to diagnose before the age of 20.” That was the standard rule that I left medical school with. These days, that is certainly not the case. You can diagnose bipolar way, way younger than the second decade, third decade of life.
Dr. Weitz: When you talk about comprehensive lab work, is there a standard panel that you’ll use for all patients or do you tailor it after doing the history?
Dr. Becker: Generally in my practice one thing, as you know in naturopathic medicine, is that it’s a very unique individual trajectory with each patient. As a rule, I do pretty comprehensive vitamin level testing and mineral level testing.
Dr. Weitz: How do you do that?
Dr. Becker: Usually through blood work. Some of the standard labs around-
Dr. Weitz: Do you use SpectraCell’s Micronutrient or-
Dr. Becker: Sometimes I use SpectraCell. I generally try to meet the patient where they’re at. I try to use conventional lab work on the outset. In most cases the labs are covered by the patient’s commercial insurance and it’s an easy place to start with people. I’ll do just-
Dr. Weitz: Including the nutrient analysis?
Dr. Becker: Absolutely. I’ll just look at Vitamin D levels, Vitamin A levels. I’ll look at mineral levels inside the red blood cells. I look at a lot of cortisol testing, hormone testing, things like that. I do use Great Plains lab and I test for glyphosate in a fair amount of my patients. Certainly my waiting list is a bit long. What happens with a lot of my patients is my staff is really excellent at saying, “Why don’t you get a hold of Dr. Kendra’s book which has a lot of healing diets in it, which reduces inflammation, and in the meantime do one of the genetic testing company tests that are out there.” By the time they come in my office they’ve already been on a healing diet for three or four months and they already have their genetic testing, so it’s a very easy way to get a jump-start with my patients.
Dr. Weitz: For genetic testing, are you talking about 23andMe, Ancestry, or-
Dr. Becker: Uh-huh. Yep.
Dr. Weitz: … specialty labs? Okay.
Dr. Becker: I’m also currently in negotiations with a company from the Northwest. We’re looking to put together my own personalized panel because as you know there’s like four billion genes in the genome and about 4,000 of them separate us from apes. About 400 of those have implications on our health, and about half of that is stuff that we can actually modulate as physicians with diet, supplements, and lifestyle suggestions. I’m looking at putting together my own personal panel. They’re in the final stages in opening up their company. I’m really hoping to move forward with them because they’re not a standard 23andMe or a Ancestry company which sells your DNA for data mining. It’s deidentified so they shouldn’t be able to identify who you are personally but you don’t know that. You really don’t.
Dr. Weitz: Unfortunately in the age that we’re in with social media and everything else, privacy’s pretty much out the window.
Dr. Becker: It’s funny because I have patients who are very concerned about sending out information, blood or saliva or whatever, for DNA analysis. I’m like, “Oh please, they already got it and if they wanted to find you they would. Trust me.”
Dr. Weitz: In the post-9/11 world, forget about privacy. As much as I would like to have privacy, I don’t think it exists.
Dr. Becker: I totally agree with you. Totally agree.
Dr. Weitz: Can you talk about exposure to toxic chemicals like heavy metals, Bisphenol A, and you mentioned glyphosate and how this might be related to anxiety in children.
Dr. Becker: Sure. Again, it comes down to whatever your genetic predisposition is. If you have a gene for example, MTHFR which is methylenetetrahydrofolate reductase, that helps convert folic acid which is synthetic into the usable form of folate. However in order to do that you need to recruit all the other B vitamins from your food and a bunch of minerals. If this enzyme is not working properly and they pathway is jammed up in some way, what ends up happening is you end up using up your B12, using up your magnesium, and some of these other co-factors in a little bit of an inefficient way. When that happens you’re robbing your body of the co-factors for any of these other nutrient pathways that would utilize those minerals.
Because this happens, it creates inflammation in the body. When we create inflammation in the body, we end up eliciting an immune response. When we have an immune response, that immune response could be misdirected if the body is out of balance. Recent research has shown us that conditions like depression and anxiety come from an inflammation state. By looking at those things, the Bisphenol A, the glyphosate, even heavy metals like lead, those things competitively inhibit the body’s ability to use the beneficial minerals and vitamins and can certainly throw a wrench in your cogwheel of the MTHFR, for example.
Dr. Weitz: How do you test for heavy metals and how do you test for some of the other toxins?
Dr. Becker: For heavy metals, it varies. Sometimes I’ll do blood. I’ll look at an RBC lead level. I’ll do a standard lead level, things like that. With glyphosate I’ll use the Great Plains lab. You asked me one other thing but I forgot what that was.
Dr. Weitz: I don’t remember either.
Dr. Becker: Oh okay, fine. Anyway but that’s how I test for those things. As far as Bisphenol A it’s just really for me, I look at genetics. I try to be really mindful about people’s pocketbooks. If we can’t make progress then I will go into the NutrEval testing and the micronutrient testing. But for the most part a comprehensive analysis and a look at some just standard conventional blood work can really, I would say 80 to 90 percent, lead you down the path to help your patient heal.
Dr. Weitz: You mentioned nutritional deficiencies. Can you explain what are some common nutritional deficiencies that may have a role in anxiety disorders?
Dr. Becker: Sure, low B12. We know with B12 it’s a little bit of a slippery slope. You can have a normal serum B12 level but still not have the B12 where you need it inside the cell. Conversely you can have B12 that looks normal and it be too elevated for that patient, which can also give that patient anxiety symptoms.
Dr. Weitz: Are you looking at homocysteine levels or methylmalonic acid? What marker for functional B12 status are you looking at?
Dr. Becker: I do the whole pathway. I do the B12, folate. I do the MMA (methylmalonic acid). I look at ceruloplasmin. I look at homocysteine and I look at C-reactive protein. That’s generally how I do it. Depending on-
Dr. Weitz: For those who aren’t aware, can you explain what you mean by the B12 pathway and how those factors fit into it?
Dr. Becker: Sure. B12 comes into our bodies via food for the most part. Then the food is broken down and the nutrients are disseminated through the circulatory system. When it’s disseminated through the circulatory system and we draw blood, that’s called the serum B12 level. That’s a level of how much B12 is in your blood. However if you have impaired pathways for whatever reason, MTHFR, COMT, any of the other to MTHFR or whatever, you certainly could have B12 that looks adequate or even elevated in the blood and then not have any of the B12 inside the cell. Then you can look at a level like methylmalonic acid which actually looks at the transmission across the cell membrane for the B12 to make sure that there’s adequate B12 inside the cell. As you know it’s a lab test that isn’t a hundred percent accurate but it gives us a best indicator because the methylmalonic acid is a byproduct of how the cell uses B12. It’s good enough. A lot of times what happens with those patients is you can’t give them B12 because it does make them anxious, impairs their sleep, or it makes their behavior worse.
You have to do something else to help the pathway, support that pathway. In some cases you use B1. In some cases I use the element molybdenum, which I’ve had very, very good success with. Sometimes you don’t do any of that and you just tell your patients to go home and eat a whole bunch of cooked green vegetables. Each patient’s really, really individual and you have to meet them where they’re at.
Dr. Weitz: What does molybdenum do?
Dr. Becker: Molybdenum, the way I describe it to my patients is it works like lubricant. It lubes up the B12 to get it through the receptor a little bit faster and more efficiently. The other thing with molybdenum is it’s a great byproduct of methylation. It tends to be very, very delicious “food” or energy for the Epstein–Barr virus, and molybdenum tends to be really, really effective in breaking down the Epstein-Barr virus also. It’s a twofold.
Dr. Weitz: Interesting. It also binds with copper. You can change your zinc-copper ratio that way as well.
Dr. Becker: Absolutely.
Dr. Weitz: Let’s talk about diet and food, and how it impacts anxiety and blood sugar.
Dr. Becker: Oh yeah, let’s do that. The first thing is I’ll practice-
Dr. Weitz: None of our kids have any blood sugar problems, right? Because they’re-
Dr. Becker: No.
Dr. Weitz: … just eating green vegetables.
Dr. Becker: Exactly. My son, my nine-year-old, plays hockey. This is a constant conversation with him about being hangry, because if he was hangry it would be so much easier to figure out what’s wrong with him. But with him, he gets in the car after hockey and he’s silent. I was like, “Your blood sugar low?” Nothing. I’m like, “Eat something. Eat something right now.” All kids are really, really different. But when kids have labile blood sugar, they certainly can get anxious. That’s always my first advice to patients and to teachers is before you’re worried about any diagnosis, feed the kid and give them something that has a little bit of quick carbohydrates and a little bit of long-acting carbohydrates, and a ton of protein. That tends to be really, really effective as far as digestion for those kids and staying power. But-
Dr. Weitz: I know my kids, right after they … When my son was done with a soccer event there was never any problem in the car because right after, the parents would always bring snacks so they’d carb it up right away.
Dr. Becker: Yeah. Yeah, we don’t have that luxury. With hockey, it’s a little different. You’re so beholden to the ice time gods. These kids get dressed and they get right in the car. Then you’re off to the next thing. You’re off to the next game, the meet, or whatever activity you have. They get right in the car. There’s not a lot of social stuff unless it’s the end of the season unfortunately.
Dr. Weitz: Oh, okay. How do you manage the blood sugar levels besides just getting some carbs in after an athletic event?
Dr. Becker: My advice in general across the board is protein in the morning. Throw out your boxes of cereal and your real milk, fake milk or whatever. When you front load kids in the morning with carbohydrates and sugar like that, they’re going to peak and then they’re going to absolutely tank. Because of that, a lot of times you can see that hangry behavior, that anxiety behavior, or however kids manifest their low blood sugar. I always say protein in the morning. For me, I’ve never been a breakfast person. I’m hypoglycemic myself so I’m really mindful of where I’m at with my blood sugar. I always say to parents, protein in the morning. I love eggs, but for me it’s very cyclical. I’ll eat eggs everyday for three weeks and then be over it and eat something else. I always recommend some really high-quality protein shake, or a piece of chicken from last night’s dinner, which is a far better source of protein or nutrients to start your day than a bowl of cereal.
Dr. Weitz: For breakfast for kids, you give them some eggs? Is that it?
Dr. Becker: Everybody is different. My kids, no. My kids get eggs, bacon a lot of times and then we mix usually onions and peppers. In the summer we do a lot of spinach and basil or garlic scapes, depending on where we are seasonally. Then for me, I would give my kids in particular they’ll have a snack two hours later. That’s generally nuts. Right now we’re on a macadamia-
Dr. Weitz: No toast or oatmeal with the breakfast? Just eggs.
Dr. Becker: Just eggs.
Dr. Weitz: Okay.
Dr. Becker: No, my kids don’t have toast. Sometimes, this time of year they’ll ask for hash browns so I’ll make either a white potato or sweet potato or a yucca hash brown but who’s got time for that in the morning? Not me.
Dr. Weitz: Okay.
Dr. Becker: But this morning my son had sausage and kale soup for breakfast. You know what I mean?
Dr. Weitz: Wow.
Dr. Becker: My daughter made herself a smoothie.
Dr. Weitz: That’s pretty impressive.
Dr. Becker: Absolutely. Then the other thing is-
Dr. Weitz: Kale soup for breakfast. Wow.
Dr. Becker: Yeah. You don’t mess around.
Dr. Weitz: You’ve got some strange kids.
Dr. Becker: I know, right? I know. Then the other thing is too is I have a big conversation with my parents about gluten and dairy. Gluten, which is the protein that’s found in wheat and wheat products is called gluten because it’s like glue. That’s why they call it gluten. If you think about that and these processed grains, you have this overexposed surface area that allows that stick gluten glue protein to stick anywhere it wants. Now, we know by research that if you have the most perfect, beautiful balanced gut and you consume gluten, you’re going to have leaky gut for up to three hours after that consumption. If you have a leaky gut it can be inferred that you have a leaky brain. In many cases those proteins go straight to the brain.
The problem with that is, is that glue sticks in those areas of the brain that very would could be the anxiety center, the aggression center or whatever in those children. Almost across the board a hundred percent, I highly recommend getting rid of gluten in the diet. That can make a huge difference with anxiety because as you know, with food allergy and food sensitivity you don’t have an immediate reaction.
You don’t consume gluten and then your throat closes, or you don’t consume gluten and then get immediately anxious although some patients do but a lot of times we have what’s called the delayed hypersensitivity reaction. The reaction comes 30 minutes up to 72 hours after the consumption of the food. You eat a turkey sandwich on white bread on Monday and now Tuesday night you’re trying to go to sleep and you have heart palpitations that could very well still be associated with the gluten that you consumed.
Dr. Weitz: Do the kids need a gluten sensitivity panel from Cyrex or one of these companies, or are you just automatically “no gluten?”
Dr. Becker: I don’t generally use Cyrex’s panel. I used to almost exclusively order the celiac panel, which had the tissue transglutaminase, the IgG, and the IgA. Then the insurance started kicking it back to me. I’ve actually stopped doing that over the last five years or so. What I do instead is I just order standard IgG testing for gluten, dairy, corn, and soy. That seems to be pretty well supported by the insurance companies that are around here in this area.
But a lot of times it’s a diagnosis of exclusion. I never tested for gluten sensitivity until about seven years ago when I had a patient that walked in the office whose kid was absolutely positively from the second she walked in the door diagnosed with a gluten sensitivity. The family just wasn’t going to get on board until I drew the labs. The labs that we use is anything greater than two is considered a gluten sensitivity. Well this kid was over 300. It wasn’t until that point, until they saw it on black and white on paper that they realized that their kid had an issue. Remove the gluten from the diet, symptoms went away. Sometimes, like I said, you got to meet your patients where they’re at. Those people needed it. They needed to see it on paper.
Dr. Weitz: Right. But if you’re just doing an IgG for gluten it might not be as accurate as some of these more elaborate panels.
Dr. Becker: Sure.
Dr. Weitz: For example, I know the Cyrex panel for wheat measures 15 different proteins in wheat that can all create sensitivity reactions.
Dr. Becker: Oh, absolutely but like I said, I tend to be a real practical naturopath. I use my diagnosis skills and my comprehensive assessment first, generally because I’m in an area that my patients are not wealthy. They pay out of pocket to come to see me to begin with. To be able to drop $300, $400, or $500 on one isolated test can be very, very financially stressful for them. I don’t do that kind of testing unless the patient comes back in the office and they’re not better. Then I’ll tend to look a little bit further. But like I said, I think it’s about 80 to 85 percent of my patients are better just with that. I tend to be really lucky.
Dr. Weitz: You tend to just exclude gluten or do you do an elimination diet?
Dr. Becker: Depends on the patient. Generally the things that I would go to initially are generally gluten, corn, dairy, and soy. Those are the four things that are usually the absolute must to remove. Again, every patient is different. I’ve had patients who have just exclusively removed gluten and their symptoms have resolved. Sometimes you need to go a little bit further and add additional things into the removal list, but I try to really be very practical and pragmatic with families because even just …
I had a woman who came in with raging anxiety. She had two young kids who she was caring for. She was like, “I’m super, super anxious.” I said, “You got to get rid of gluten.” She’s like, “I’m not ready to get rid of gluten.” I was like, “All right. Call me when you are.” I would get emails from her three or four weeks later, “I’m so anxious. I feel I need to go on a pharmaceutical. What else can I do other than removing gluten?” I’m like, “Nothing. You have to start there.” Finally she did it and she lost 60 pounds. But again, you just got to meet patients where they’re at. Sometimes they’re not ready in spite of the fact that they’re paying for your advice to walk through your door.
Dr. Weitz: Dr. Becker, the “Gluten Nazi.”
Dr. Becker: Indeed. That’s exactly what my kids call me. Indeed.
Dr. Weitz: How do you assess gut health and how do you treat problems with gut health?
Dr. Becker: Again, it all depends on what’s in there. Who do I use? I use Genova’s test which I really, really like. I always add the zonulin on there.
Dr. Weitz: You’re talking about the GI Effects stool test from Genova labs?
Dr. Becker: Correct. I use that because it’s easy to rule out whether there’s a parasite or some pathogenic bacteria. It’s a relatively easy collection test. Genova’s really great when working with parents with their insurance and really helpful with billing and things like that. That test tends to be really effective. As far as treatment, it all depends on what you’re seeing. If there’s a parasite or a bad bacteria in there, you got to get rid of that first.
If it’s just a matter of commensal bacteria being out of balance, then you got to support that. But that test is really great at giving you a nice smattering of what is wrong and what is right. I use a lot of probiotics. I use a lot of gut healing combination products.
Dr. Weitz: How would you support commensal bacteria out of balance? Let’s say you have potentially pathogenic bacteria are elevated and maybe slightly lower levels of commensal bacteria. How would you address that and then put to your patient?
Dr. Becker: Well it depends on the patient. It depends on what bacteria is high and what bacteria is low.
Dr. Weitz: Okay.
Dr. Becker: Sometimes you can use things like chlorophyll. You can use molybdenum, which helps with acetaldehyde. You can use immunoglobulins or colostrum. It all depends on what you’re seeing. Sometimes you give specific strains of probiotics based on what the patient needs. You can use specifics, just lactobacillus gasseri or lactobacillus acidophilus, depending on what you’re trying to really support in that patient. It’s difficult to say what I do because I am not an always or a never kind of girl. You know-
Dr. Weitz: If your lactobacillus is low, you might particularly try to support that particular type of bacteria?
Dr. Becker: Yeah, absolutely.
Dr. Weitz: Okay. Then what if there are pathogenic bacteria and/or parasites? What type of treatment will you do then?
Dr. Becker: Well it’s different for every patient. I have prescribed antibiotics. I’ve used herbal combinations. I have used liquids, tinctures, all stuff like that. I’ve used mastic gum. I’ve use glutamine. It all depends on what the bacterias and what the symptom picture is for that child.
Dr. Weitz: Mastic gum is something you use for H. pylori?
Dr. Becker: Mm-hmm (affirmative). Absolutely.
Dr. Weitz: Okay. What about nutritional supplements for children with anxiety?
Dr. Becker: Again, it depends on the kid. You have to figure out where the anxiety is coming from. Is it a food allergy problem, is it a cortisol issue, is it a lack of sleep or a home stress? Things like that. You certainly could use amino acids like glycine which are really, really effective. Sometimes you just give Vitamin D.
Dr. Weitz: What does glycine do?
Dr. Becker: Glycine binds to the same receptors that benzodiazepines do. It works like a benzodiazepines without the addiction. Give Vitamin D. Vitamin D is a precursor to dopamine, which is a happy hormone. Those things can be really effective in kids. Fish oils. It all depends. Sometimes they just need a probiotic.
Dr. Weitz: What levels of Vitamin D do you supplement with children?
Dr. Becker: All levels. Generally I try to keep my patients between 55 and 80 or 85.
Dr. Weitz: That’s pretty aggressive.
Dr. Becker: Yep. I do what I can.
Dr. Weitz: Good, good. I know you’ve touched upon genetics a little bit. Can you talk a little more details about a few genetic factors? I know you mentioned MTHFR. What are some of the other genetic factors that can play a role in anxiety in children?
Dr. Becker: Sure. There’s another genetic mutation or marker called COMT (catechol-O-methyltransferase). That basically works like the garbage man up your neurotransmitter system. It picks up all the old, used up neurotransmitters. If that system is not working properly you basically have all these random neurotransmitters that have never been recycled that potentially could refire at any time. Then when you have the refiring you again create inflammation. People that are what’s called COMT upregulators … I always compare the COMT upregulators and the COMT downregulators to the Eeyore versus the Tigger, which we all love Eeyore but we all know he’s chronically depressed. We all love Tigger but we all know he’s got ADHD. That’s how we look at it.
The truth of the matter is that there are definitely personality types that go along with individuals that have COMT. They are what we call the 0 to 60 types. They can be provoked very easily and then get very angry very quickly. That’s a classic sign of a COMT upregulator. The problem with that is when you get angry you raise your cortisol. When you raise your cortisol, you raise your blood sugar. When you raise your blood sugar you increase the leakiness of the blood-brain barrier. It’s a big trickle-down effect. Based on that, what we also know about people that are expressing their COMT mutation is that they can be estrogen-dominant. We know that estrogen in general, whether it’s real or fake, can cause leaky gut. Leaky gut … Because 90 percent of our neurotransmitters are manufactured in the gut, really needs to be intact for proper neurologic functioning.
Dr. Weitz: Let’s say you do have a patient with or two copies of the COMT single-nucleotide polymorphism variant. How do you treat that?
Dr. Becker: Again, it’s very different because sometimes you have patients that are COMT upregulators that are very, very sensitive to B vitamins. Everybody needs Methyl B12. Period, end of story. It’s gasoline for our cells. However, if you give a lot of Methyl B12 to somebody who is a COMT upregulator, you can make them super anxious, really mean or hate you. It doesn’t-
Dr. Weitz: What do you do then?
Dr. Becker: Depends on the patient. Sometimes you have to use a different form of B12. Sometimes you don’t use any B12 at all and hope that they can tolerate green vegetables. Sometimes you give them B1 or B2, or sometimes you give them a B-complex that avoids B6, 9, and 12. It all depends. Sometimes you just start with minerals. Every-
Dr. Weitz: What other form of B12 will you use besides Methyl B12?
Dr. Becker: Depends on the patient. It could be adenosyl or hydroxy.
Dr. Weitz: Okay. What about patients who have down-regulated COMT?
Dr. Becker: If they are not methyl-sensitive, sometimes those are patients that require higher doses of B12. It all depends. Sometimes you’d have to support the adrenals. Sometimes they have Epstein-Barr. You get a whole wide variety of patients across the board and unfortunately there’s no one-size-fits-all.
Dr. Weitz: Okay. What role can exercise play in reducing anxiety in kids?
Dr. Becker: Well we all know that exercise is the number one misused drug in this country. It is completely underutilized. By exercising we know that we first of all burn off a lot of simple carbohydrates. Number two, it increases all the happy hormones and the endorphins in the brain. It improves sleep, can actually balance brain waves, and certainly help a physical body release any tension or stress that it’s holding. I think it’s grossly underused in this country for sure.
Dr. Weitz: Also increases brain BDNF levels that promotes learning.
Dr. Becker: For sure. Absolutely. It also helps with the translation of short-term into long term memory I believe. But I think BDNF does that, too, really.
Dr. Weitz: Yeah. It’s interesting how many schools now because of budget problems and stuff have cut down on exercise programs and phys ed.
Dr. Becker: Mm-hmm (affirmative). Recess even.
Dr. Weitz: Yeah. What other lifestyle factors can be helpful for helping kids to manage anxiety disorder?
Dr. Becker: As a rule I say no screens whatsoever two hours prior to bedtime. Come up with a pretty, I hate using the word “regimen,” but regular bedtime routine.
Dr. Weitz: Well what if all their homework is online and they have to submit it online.
Dr. Becker: Well in my practice I have kids on IEPs and 504s and I regularly write letters to not do any homework. It’s just part of my treatment plan. I don’t believe in it.
Dr. Weitz: What age is that?
Dr. Becker: I use it for all ages because I don’t … I-
Dr. Weitz: No homework?
Dr. Becker: … don’t believe in homework. Nope. Absolutely not. Your brain’s a muscle. It needs a rest. You’re going to go to the gym and work out for six hours, and then go home and work out for another four hours?
Dr. Weitz: What school is going to allow your kids not do homework?
Dr. Becker: If they have a doctor’s note, they get it done in school.
Dr. Weitz: Really?
Dr. Becker: Oh yeah. Yep. For the patients that don’t require a doctor’s note, that have 504s and IEPs and all that, it’s the first thing I tell them to say: “You go in their with your advocate if you have an advocate and tell them no homework.”
Dr. Weitz: Wow.
Dr. Becker: There’s no evidence that shows that homework that kids are doing at home is actually … Number one we know the test scores have gone down in the last nine years since Common Core, number one. Number two, that homework actually increases or enhances learning in any way.
Dr. Weitz: Wow. You should just put that on your website: “The kids that I treat don’t do homework.”
Dr. Becker: Oh my gosh.
Dr. Weitz: Your waiting list is going to grow. You’ll have a three-year waiting list.
Dr. Becker: Well, there’s lots of schooling programs that don’t require homework. Montessori doesn’t give homework. Grant it, the Montessori schooling program is generally over by 8th grade. Waldorf generally doesn’t start homework until around 5th or 6th grade. That homework is very constructive. It’s all project-based. You’re not sitting there writing answers on a sheet that somebody thinks is the right answer. It’s a creative project. It’s really only the public school that’s challenged. Countries all over the world don’t do homework. It’s only here.
Dr. Weitz: Wow. Yeah, my kids are both in college now but they’ve had hours of homework everyday for years, years and years. It’s surprising to hear that. What about strategies for managing anxiety, like meditation, yoga, breathing?
Dr. Becker: Yeah. All the things. I teach the kids in my practice the “I love you. Goodnight.” It’s what I call the “I love you. Goodnight.” What I teach them is that when they get in bed, they start with the top of their head and they say, “I love you. Goodnight.” to every single one of their body parts. “I love you. Goodnight, forehead. I love you. Goodnight eyes. I love you. Goodnight nose.” They do this throughout their whole body. I’ve never had a kid that’s gotten past their knees.
Dr. Weitz: Wow. It’s a variation of the progressive relaxation strategy, right?
Dr. Becker: Absolutely but you can’t teach a six-year-old how to do progressive relaxation. It’s really a take on counting sheep. It’s just a repetitive, calming exercise.
Dr. Weitz: Right.
Dr. Becker: But we all know yoga, any of these relaxation exercises, prayer, devotions, whatever it is, is very, very beneficial for sleep. Sometimes what you have do is, it’s not even about what the activity is … Here’s a funny thing. Before I became a doctor I was a nurse. I went to nursing school. I went to nursing school long before nursing was what it is today. We held our patients’ hands, we talked to them. We sat on the edge of their beds and asked them how they were feeling.
It’s a different experience that nurses have now. I’ll never forget, you wait all this time to get into these nursing classes. I get into my first nursing class and the teacher said to the class, “You have to remember that when patients are anxious about sleep, you can tell them that it’s okay to not sleep and to just lie there and take a rest.” For me, still after all these years that absolutely resonated. I tell that to my patients all the time because there is nothing worse than having anxiety about not being able to sleep when you’re trying to sleep, and then you can’t sleep. It’s just awful.
Dr. Weitz: Right.
Dr. Becker: Sometimes it’s just a matter of making a space for those people, those patients. Even kids, because kids have that level of anxiety at this point, too. You just tell them that it’s okay and just don’t do it. Just lie there and take a rest.
Dr. Weitz: How about talk therapy for anxiety?
Dr. Becker: I think it depends on the talk therapist. I think that’s really a decision that has to be made by the sufferer and the family because I think in some cases, talk therapy can be really, really effective. The problem here in Connecticut is that there’s been a lot of legislative action around what can actually be discussed in talk therapy. I think that when you’re going to a licensed provider, you’re regulated by the state. I worry about that. I almost think that talk therapy could be much better in the confidence of somebody who’s qualified but isn’t a licensed therapist, if that makes any sense. Maybe a Reiki practitioner, a local pastor, or somebody like that.
Dr. Weitz: Interesting. What about cognitive behavioral therapy?
Dr. Becker: Again, I think it’s a personal choice.
Dr. Weitz: Okay.
Dr. Becker: I think there has been some success with it. It’s generally not my first line of recommendation unless a patient actively seeks it out themselves. But I think you have to remember with any therapy it’s a little bit like dating. You have to remind patients that you’re not going to schedule an appointment with a therapist that your friend liked and loved, and go in there and have a magical relationship. You may have to see two or three different therapists before you find the one that’s really effective for you.
Dr. Weitz: Last question. I read in your blog post that you find chiropractic helpful for children with anxiety.
Dr. Becker: Absolutely. My husband is a chiropractor so I’ll preface my statement by saying that, but we know that chiropractic removes interference. We know that things that cause interference in our body makes us sick. When you get a chiropractic adjustment, not only are you removing interference from a spiritual level, but you’re also increasing endorphins, oxygen, and healing components of your immune system into your brain and into your nervous system. Of course it is beneficial.
I’ve had lots of patients too over the years that have come into my office that I’ve said to them, “I’ll be happy to sell you a room full of supplements and do a ton of lab testing but I think a lot of what you’re experiencing is coming from your spine. Perhaps you want to try chiropractic.” Sometimes it’s all they need. Sometimes they will require a combination. But chiropractic can really be a game-changer for people. I think the biggest challenge is people don’t normally think of treating something like anxiety, ADHD, or even autism with chiropractic as a primary form of treatment.
Dr. Weitz: Interesting. Music to my ears as a chiropractor.
Dr. Becker: I know, right?
Dr. Weitz: Thank you for the interview. For those listening, how can they get a hold of you and find out about your programs?
Dr. Becker: Sure. My website is drkendrabecker.com. That’s where my blog is, all of my speaking engagements and things like that. My office website is FamilyWellnessCenterofConnecticut, or fwcct.com. There you can schedule appointments, purchase supplements, see what classes we’re offering at the office and things like that.
Dr. Weitz: That’s great. Thank you so much, Dr. Becker.
Dr. Becker: Oh, my pleasure. Thanks so much for having me.
