122: Anxiety & Skin Rash Connection w/ Dr. Sara DeFrancesco

Anxiety can greatly affect a person's quality of life, but did you know it can also impact the health of the skin?    

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My guest today is Dr. Sara DeFrancesco. Dr. DeFrancesco is a holistic, root cause Naturopathic Doctor, Licensed Acupuncturist, and the founder of Thriving Force – an investigative medicine clinic that specializes in digestive, immune, and brain health problems.

Dr. DeFrancesco helps people turn their brain and health back on by healing root cause metabolic problems (like overlooked inflammatory triggers, stealth infections, and nutritional deficiencies) combined with holistic neuroscience so you can heal the cause of what is preventing you from being well.

Join us as we discuss the connection between anxiety and skin rashes.

Have you dealt with anxiety-induced skin rashes? Let me know in the comments!

In this episode:

  • What is anxiety?
  • What are some reasons that people feel anxious?
  • Understanding what neurotransmitters are and how they play a role
  • How is lack of sleep (or insomnia) increases anxiety
  • Histamine's role as a neurotransmitter – is this a problem?


“The worse your sleep habits or your insomnia is, the worse your blood sugar is, which means the worse your anxiety is, and then it's this vicious cycle.” [6:12]

“Histamine is an excitatory neurotransmitter, so it can make people feel anxious or really excitable.” [9:52]


Find Dr. DeFrancesco online

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122: Anxiety & Skin Rash Connection w/ Sara DeFrancesco, ND, LAc FULL TRANSCRIPT

Jennifer: Hi everyone. Welcome back. I've got a good friend with me, and I am super excited to have this conversation today with her. It's her first time on the show, and we are going to talk about a topic that sometimes can be difficult to dive into, but something that you guys know is important to me to address, and that's anxiety and depression and things like that, that can often times coincide with skin rash issues. My friend, Dr. Sara DeFrancesco is a holistic root cause naturopathic doctor, licensed acupuncturist, and founder of Thriving Force, an investigative medicine clinic that specializes in digestive, immune, and brain health problems. Dr. DeFrancesco helps people turn their brain and health back on by healing root cause metabolic path problems like overlooked inflammatory triggers, stealth infections, and nutritional deficiencies combined with holistic neuroscience so you can heal the cause of what's preventing you from being well. And she also has a fantastic website over at doctordefrancesco.com because she does have an Oregon clinic and a virtual practice. Thank you so much for joining us.

Dr. DeFrancesco: Yeah, I'm so excited to be here. This is such an important topic. I just can't wait to dive in, and I hope it's helpful to everyone.

Jennifer: Yeah. So, Dr. DeFrancesco, you deal a lot with anxiety. That was one thing that when we started talking about this topic, I was like oh my gosh, we have to dive into the whole anxiety piece. And there's a lot of connections that people don't even think about. But I would love for you to, first of all, what is anxiety? Tell us what that is because I think a lot of times people aren't entirely clear on what it is.

Dr. DeFrancesco: Yeah, absolutely. Great question. So a lot of people are aware that they have anxiety because they feel anxious in certain situations. They can manifest physical symptoms like heart racing, racing thoughts, sweating, so it might be that intense. Or they might notice that they just feel keyed up like their adrenaline is high in certain situations. And often this will make someone react by trying to avoid those situations. So that's a big thing in anxiety. And then what can also happen is sometimes people may not feel that real keyed up, high adrenaline feeling, but they may feel a ton of overwhelm, and they just feel like they can't push past the overwhelm. And they can also feel like they might have anxious thoughts, so just a lot of worry about the future. And a very basic way to describe it, the way that anxiety is different from depression, is anxiety tends to be worries about the thoughts and worrying about things that might happen or worrying that you might not perform well or worrying something's going to go wrong or that it will be too overwhelming for you, while depression… And again, this is a big generalization, but depression is often the brain is really kind of stuck in the past, where anxiety, the brain is really stuck anticipating the future in a negative way.

Jennifer: And that could go hand in hand. Correct?

Dr. DeFrancesco: Absolutely. So some people experience them at the same time. Some people experience bouts of depression and bouts of anxiety. Kind of the good part about anxiety is a lot of times, even though people may experience extreme fatigue and insomnia, the anxiety, sometimes it makes them feel like they have a little energy to burn. And so if you're listening to this and this is making sense to you, the good part is you have this pent-up energy. We just need to redirect it, and then we can really have amazing results for your health and for your mood.

Jennifer: Well, so what are some of the reasons why people might feel anxious? For example, I know when I was dealing with my skin rash issues, I was really afraid to meet new people, number one, because I was afraid they were going to look at me or stare at me or ask questions about why I didn't understand how to wash my hands. I got a lot of weird questions that were very judgmental, but I also just became afraid of the next flare. If I had any sensation, I was like oh my gosh, is this coming back again? And it took a long time for that to go away. But yes, I'm sure there's habitual patterns that we can get in and societal things that can contribute to this, but what are some things that people initially don't even realize are connected that could be driving their anxiety?

Dr. DeFrancesco: Yeah, absolutely. So there can be situational anxiety, or there can be a condition that you have anxiety about others seeing that or anxiety about sharing that. And so there's really two things that we have to consider with anxiety. One is our emotional and spiritual stress response, and the other is our internal medical stress response. And these things are not separate. I think that's what's so interesting and freeing for people who are able to heal their anxiety through these root cause methods where we're looking at the whole body. So some typical things that are happening internally for people, medically for people because anxiety, depression, things that are labeled as mental health disorders, they're not. they're medical disorders that manifest with brain symptoms. And so they change your mood. And so I think first of all, we have to reframe that.

Dr. DeFrancesco: And so one of the biggest starting places I think is really focusing on food and blood sugar. So your audience is probably very familiar with that. But often people will be dealing with anxiety. They'll also have insomnia. And the problem is what's happening here is the insomnia is changing the stress hormones, and it's actually changing the way that blood sugar is being regulated throughout the day. So the worse your sleep habits or your insomnia is, the worse your blood sugar is, which means the worse your anxiety is, and then it's this vicious cycle. So first of all, we absolutely have to break that. And that cycle all by itself affects the digestive system. It affects the hormone system, and it affects the neurotransmitters. So people often have gut infections, leaky gut, inflammation from poor nutrition. They can have nutrient deficiencies. So some nutrient deficiencies that are very common would be B12, B6, folate, so your B vitamins there, also magnesium, vitamin D, zinc, and iron.

Dr. DeFrancesco: And so iron, this is a big one, especially if you're a menstruating woman. If you have heavy menses, then you may be depleting iron, and that heavy menses we have to find out well, what's the cause of that hormonal imbalance? So hormones are also an issue because if there's heavy bleeding, it's going to deplete the iron. But also when there's too much estrogen and not enough progesterone, that can lead to anxiety, especially anxiety and sleeplessness. And if you're noticing that your anxiety is worse in the second half of your cycle, so from ovulation up until the first day of bleeding, then that's a sign that maybe progesterone is an issue for you.

Dr. DeFrancesco: Now the reason that's important is because progesterone is a driver of GABA, and GABA is our hit the brakes on the brain neurotransmitter. So GABA hits the brakes and says slow down. Go to sleep. Everything's fine. It's cool. You can handle this. And glutamate is the opposite. Glutamate is like go, go, go, go, go. Got to get all the things done. And often a lot of women are experiencing, especially if they're running a business, they're taking care of their family, especially moms, it's like nighttime kind of becomes this time where it's like oh, everybody is in bed or calming down, and I have to get all the things done. And we can get really revved up at the wrong times and again start this cycle with the cortisol being high and the sleep issues.

Jennifer: Can I actually ask you about this really quick, is that just in case for someone who doesn't know what a neurotransmitter is, if that's a first time they're hearing that term, what is a neurotransmitter?

Dr. DeFrancesco: Oh, great question. So think of it this way, is that your body, the reason you have to eat food is because you need to produce the proteins that your body needs to run itself. And so neurotransmitters are a protein that is produced actually in the gut and in other places in our body and also in the brain. And it affects your brain function, and it affects your mood, your cognition, your memory, but it also has effects throughout the entire body. So I know we're going to talk about histamine, and that's a really good example of that as well. So neurotransmitters that you probably heard of would be serotonin, dopamine, and we're going to talk about histamine too.

Jennifer: Yeah. So let's dive into the histamine piece to this because with skin rashes, especially people who are struggling with eczema, a lot of the big concern always is is the itchiness being driven by histamine? So it's not uncommon for… Actually, most of my clients are usually, they're taking Zyrtec. They've tried Benadryl. They're trying all these different antihistamines to just stop the itch. And even sometimes that's not enough to quell it. So why would histamine… Number one, why is it a neurotransmitter? And why should we be concerned about this, especially in terms of anxiety?

Dr. DeFrancesco: Yeah. So histamine is an excitatory neurotransmitter, so it can make people feel anxious or really excitable. I mean, it does help us focus to an extent. So we need a normal level of histamine. But when we have either inflammation from within that's driving too much histamine… So an example of that would be a gut infection, and the body's reaction to parasites and to allergies and to foods that are strong in histamine or food allergies that you have, the natural reaction is to produce histamine. So someone could have a gut infection, for example, or someone could be going through allergy season or both. So that's also something to watch for, is for some people, if you're going through allergy season and it's really, really bad, but then when allergy season is over, it doesn't completely resolve, then we want to ask well, hey, it's obviously not just our environment. What else could it be? What's going on with our internal environment?

Dr. DeFrancesco: And so it's interesting here, is people will often experience flushes of the skin. They'll experience this feeling really spacey after meals. They'll experience itchy skin, rashes, a lot of brain fog, a ton of brain fog. So if there's skin issues, brain fog, anxiety, and seasonal allergies, or if we look at a blood chemistry panel, and we see that the eosinophils, which also are associated with allergies, are high, that we need to look into that and see what is going on with histamine. Now, to tie in the hormonal piece again, is histamine actually is a normal part of ovulation, and it rises with estrogen. So when estrogen is too high, then histamine can be too high as well. So everything is connected, and we just have to look at the body and say what's the story that the body's trying to tell us? Because each one of your symptoms is telling a story, and if we look at the pattern, we can see where we need to investigate.

Jennifer: And so someone listening to this might go, “Wait. I read online that I should avoid all histamine-rich foods because that could be triggering all my problems.” Do you think generally speaking that that's the best way to go? Or would investigating the actual reason rather than just jumping on the food bandwagon of cutting things out be a better idea? What do you think?

Dr. DeFrancesco: Yeah, I think we definitely have to investigate, and I think that to temporarily cut things out is a test to see hey, do you feel better if you avoid high-histamine foods? Do not ask me to list them all because it's such a long list. But we can definitely link. But it's one of those things, it's like the FODMAP and the high-histamine foods are the ones that I can't memorize. Like gluten-free, dairy-free, that's easy. Autoimmune Paleo is easy, but actually, for me at least, I have to take a list with me if we're talking about FODMAP and histamine. But it is a good way to test because if you go lower histamine on your food and you notice a difference, then that's a clue. Another thing is that people will not do well with leftovers. So another test that you could just do an experiment is to see if you're eating all fresh foods, do you feel better? Or if you are freezing leftovers right away and then reheating them from frozen, that can reduce the histamine content.

Dr. DeFrancesco: And then, yeah, the other thing about histamine is there is an enzyme that helps to break down histamine called DAO. And you can actually take that to see if it mitigates your histamine response. So a lot of times with folks who are dealing with histamine issues, we'll do things like vitamin C and quercetin and nettles, which is a type of herb, to really just calm down that overall histamine response, especially in times of seasonal allergies. So it's also a great seasonal allergy approach, even if you don't have histamine issues throughout the year. And then we'll also experiment with a DAO enzyme to see if that gives them relief because if those things work, now we know we are dealing with a histamine issue, and now we can go after why is that happening? Is it nutrient deficiencies? Is it gut infection? How can we improve the microbiome? I definitely am a big fan of, let's not blame the food. Let's rebalance the microbiome because if we start just cutting out foods, your world is going to get smaller and smaller and smaller, and the microbiome actually suffers from cutting down the foods to be such a small list.

Dr. DeFrancesco: So what we want to do is just get clarity, get an action plan based on what the real cause is and then have you expand your life. That's what this is all about because when you're dealing with anxiety… And I've been there. I used to have anxiety. I used to have panic attacks. For me, it was celiac disease, a traumatic brain injury, and a parasite. Yay for me. But I learned a lot through that, and I don't miss any of that stuff with my patients. I had to go through dozens of doctors who, bless them all, they really did their best and tried to help me, but they kept just trying to give me calming herbs. Just take lavender. Just take Rescue Remedy. And those things are all great. I love herbs. I love using those things as part of the plan. But we have to look at what the underlying cause is. We can't just be putting bandaids on, supplements as bandaids, or restrictive diets as bandaids.

Jennifer: Yeah. And you know what's interesting [inaudible 00:15:45] place for us to go with this conversation too is about anxiety being a superpower because I have never heard that before. And when I read that, I was like whoa. That is a completely different way to view the anxiety that you feel. So would you care to talk about that with everyone and share your insights so that maybe everybody here who's listening, who feels a lot of anxiety around what's going on with their health and their skin and just life, maybe you can actually turn some light bulbs on for them, and they could see their circumstance from a much different perspective?

Dr. DeFrancesco: Yes. Yes, yes, yes. Absolutely. This is my favorite topic. So if you're listening to this, and you're dealing with anxiety, first of all, what I want you to know is I know it sucks. I've been there. I'm not going to try and say it's all rainbows and unicorns. It's not. It can be terrifying, especially if you're dealing with acute anxiety that is keeping you from your day-to-day tasks, keeping you from your loved ones, keeping you from the things you're passionate about or if you are experiencing panic. I mean, it's awful. And I want to invite you to look at your anxiety as being your filter for the world and showing you what is congruent with what is in your highest good and your best version of yourself and what is not. And the truth is that people who are anxious are often very empathic, very intuitive, but there is this inflammation that is getting in the way of their ability to know their internal self and also communicate with others. So when you deal with that inflammation, you allow yourself to recenter, and you're still going to have that sensitivity to your nervous system because I think that's what this is. Anxiety is a nervous system sensitivity with inflammation and high adrenaline. That's often the basic combination.

Dr. DeFrancesco: And so when we take away that high adrenaline state and we take away the inflammation, now you've got this sensitive, tuned nervous system that you can use to be your best self, to really connect with others in a way that is often difficult. And this is something we're missing so much in our society, is we're missing compassion and having empathy and really looking into someone's eyes and connecting with them. So know that you are super. You're not broken. You're super. We just have to help you find the best way to use that energy so that feels good to you.

Jennifer: That is really, really neat. And I say that… As I'm listening to you, I'm remembering when I was in college, I had such severe… And some people know this about me, and I don't mind sharing, but I had such severe depression. I was on Prozac, and they wanted to put me on mood stabilizers. And I got to the point where I would have, I guess, a bit of agoraphobia and would not leave my apartment. And I was failing in my courses and my studies. I was very anxious, very depressed. I would have bouts of rage. And so I know what it's like to live in a very anxious state. And if someone had shared that with me, I truly believe that that perspective shift…

Jennifer: Because you always feel broken. That was always how I felt. The reflection back from the world was that I was broken. I was the problem. But I think that's a really powerful perspective shift, and I really appreciate you for sharing that because I think everyone here needs to hear that kind of message because what every listener is going through or their spouse or their child, it's difficult. Whether you're dealing with the skin rashes or you're supporting someone else who is, that can also be very stressful. And to just know that that level of anxiety that they're feeling right now is actually, there's something good in it. You're not necessarily this broken, damaged individual that you just can't function in life and in the world, and you're not meant to be. I mean, I was in a really dark place for a long time. That is such a powerful thing. Thank you so much for sharing that. I really appreciate it.

Dr. DeFrancesco: Oh 100%. I mean, I've just seen this time and time again because when people are relieved from the anxiety, it's like all of a sudden they're like, “I'm just seeing things a lot more clear. And I'm seeing what I'm grateful for. I'm seeing the things that I love. I'm seeing the things that I have to shift,” and it's so, so important. And when we are in this hyper-anxiety, hyper-cortisol state, we actually can't make new decisions. We're in survival mode. We're just doing the same over and over and over again. And then we find ourselves lost. And so I really think for any health condition, whether it's skin issues or depression or anxiety, it sucks. I'm sorry for those of you who are in the midst of it right now. It sucks. And I invite you to see this as your wake-up call. I invite you to make this your transformation because it's an opportunity. One of my teachers in Chinese medicine school would always say the worst things get, the more opportunity there is for change. And I've really seen that to be true.

Jennifer: That is really beautiful. That is so beautiful. And actually could I ask you… If everybody's listening to this, I'm a big fan of breathing exercises. Do you have one breathing practice that you would love to share with everybody that could help them if they're really anxious that they could tap into just for a minute, two minutes, something like that to help ground them and help decrease that anxiety level?

Dr. DeFrancesco: Absolutely. So the two things that I recommend that you can do immediately is get outside, ideally in some sort of nature. It's okay if it's just like a patch of grass outside your apartment, but get out there and use nature and use your breath because this is available to you at any moment. So I like the breathing practice of breathing in for four and then breathing out for eight. When you are breathing, what you're doing is you're regulating your nervous system through the vagus nerve. So the vagus nerve connects the brain and the gut. It connects every organ in between. It's the longest nerve in your body, and you can use it by breathing because it comes down the front of your throat. So anytime you are doing your deep breathing, you're activating it. You can also activate it by singing or by gargling. Those are other ways to do it.

Dr. DeFrancesco: And then the reason I say go outside is because nature is instantly going to calm you down with anti-inflammatory cytokines. So they're just… That's a fancy word for messenger cells that you can't see. But I'm not even talking about hiking or anything like that. I'm just saying being in nature, the plants are going to calm your system down. And we actually have a lot of studies out of Japan about forest bathing, is what it's called, and they've shown this brings down cortisol. It makes your immune system work smarter, not harder. So it literally makes the natural killer cells get all the bad pathogens, but not your own cells. And it brings down blood pressure. It brings down heart rate, all those things. And then I recommend that you get your feet on the ground, make sure they're warm first because if it's the time of year you're listening to this and it's winter, you could still do this, but make sure you get a hot foot bath before and after, but get your feet on the ground because you're going to get an electron exchange between your body and the earth, and you're going to be able to discharge some of that frenetic inflammatory energy.

Dr. DeFrancesco: And all of this stuff is really important. We talked a lot about the body today, and now we talked a little bit about nature and breathing, but we really need to address, in my opinion, not just anxiety, but all of these issues that are chronic inflammatory. We need to address them through the root cause of the body, but also by up leveling our minds and refocusing because when we're in that high cortisol state… I said earlier, you can't make different decisions, so you can't do decide that you're going to eat a better breakfast or that you're going to go for a walk, even though you would normally be on your phone. So we have to bring that down. But every moment that we're in high cortisol, we're actually signaling our body that we're in distress, and now we're not making the healthy proteins that become our hormones, our neurotransmitters, all of the things that we need to feel well and feel vibrant and alive. When we are stuck in cortisol, we're making proteins that are inflammatory.

Dr. DeFrancesco: And so when you decide that you are going to work on your mind through your breath, through nature, through a practice of meditation, through quitting complaining, then you can change your biochemistry. So this is where the science meets the spirit, and that's something that has been blocked in our society for hundreds of years. And we need to undo that, because [inaudible 00:25:45] our health in the first place is so that we can live better and more full, vibrant lives so that we can make a bigger impact so that we can be there for our loved ones. So we really need to start bringing our heart back into this medicine, and I invite you all to do that. I hope that this has been helpful to get started with that.

Jennifer: Yes, absolutely. Oh man. I'm like preach. Keep on preaching. I agree with you 100%. Well, you also have a really great gift for everyone. It's called the three-step strategy to heal digestive, mood, and memory problems. And they can go and download that off of your website. We'll put the link directly to that free gift in the show notes. I think, gosh, you've got such great information, great content over on your website. And everyone can find you at thrivingforce.com. Correct?

Dr. DeFrancesco: That's right, yes. And you guys, this guide, it's not like a one page whatever, you're going to throw it out. I made it because this is what I wish someone had given me when I was having panic attacks. And I have had people write in and say they followed the steps, and they're no longer having panic attacks, which is crazy, amazing. I mean, that's how much power you guys have. And it's simple stuff. There's nothing you have to buy. It's just very simple. So I hope you check it out.

Jennifer: Awesome. Well, thank you. And on top of it, you've got a great Instagram account as well, which I love to follow. So you should definitely go check her out there if you are on Instagram. But I'll put all of her links in the show notes. Dr. DeFrancesco, thank you so much for joining us.

Dr. DeFrancesco: Oh, thank you. My pleasure.

“The worse your sleep habits or your insomnia is, the worse your blood sugar is, which means the worse your anxiety is, and then it's this vicious cycle.”