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GABA helps 14-year-old with Tourette’s Syndrome (the tics and sleep), and tyrosine makes him happier and his mind sharper

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gaba tyrosine teenager

We typically associate low GABA, a calming neurotransmitter, with a physical-type of tension- anxiety that also often affects sleep. However there is evidence that low GABA is also a factor in other conditions. One of these conditions is Tourette’s Syndrome, which is characterized by the presence of chronic tics which can be motor/movement and vocal. In today’s blog I share some research that suggests a deficit in GABAergic transmission may contribute to symptoms in Tourette’s and a case study where a teenage boy found relief from his tics when using the amino acid GABA as a supplement. GABA also improved his sleep. He also made some dietary changes – no gluten, no sugar and no caffeine – and supplemented with magnesium and melatonin. The amino acid tyrosine, used as a supplement, also improved his low mood and focus, both of which can be issues with Tourette’s.

Kim, a mom in this community, shared this wonderful feedback about her son in response to a Facebook post a few years ago:

Because of your book, I started using GABA for my 14-year-old son with moderate to severe Tourette’s Syndrome, and the results have been significant. Highly recommended for tics, and sleep for these individuals. Thank you.

I asked her how much GABA he used and how often and she shared this:

He used 750mg GABA nightly before bed, and if tics are really active then additional 300mg. Lots of water and a balanced diet with no caffeine…. life-saver.

Keep in mind that 750mg is considered a high dose. We typically start with 125mg GABA and increase based on each person’s unique needs. There is the temptation to think “I have tics and this is a very severe condition so I need a high dose to start.” You don’t want to be thinking like this. Some people may not need this much and others may need this high dose. We always use the trial method to figure out the ideal dose.

She also shared that when he added tyrosine, he saw benefits from that amino acid supplement too:

He recently added 300mg of l-tyrosine, and it promotes happiness and a sharper mind, due to brain fog. He says he really notices a difference. He has read your book as well.

How wonderful is this? GABA helped reduce his tics and improved his sleep, and tyrosine improved his mood and focus.

I love that he’s read my book – good for him and this mom! It’s never too early to have you and your child read this information. It’s empowering for them so they understand the changes they need to make and why these amino acids, dietary changes and elimination of caffeine make such a difference.

I recently checked in to see how he is doing now and asked what other nutritional approaches helped/help other than GABA, a balanced diet and no caffeine. She shared this:

He’s gluten free, magnesium for sure for the muscle tics, and melatonin for good sleep (Touretters need a routine sleep schedule).

He’s 18 now and is doing way better as he matures, but GABA no doubt has improved his life. We promote GABA and educate others as much as possible.

All this is so great to hear and I love that they now help to educate others about GABA too.

I appreciate that she gave me permission to share, hence this post. (The image above is a stock image and not her son.)

Tourette’s Syndrome and reduced GABA function

This paper, Reduced GABAergic inhibition and abnormal sensory symptoms in children with Tourette syndrome, describes the condition and the role of reduced GABA function:

Tourette Syndrome is characterized by the presence of chronic tics. Individuals with Tourette Syndrome often report difficulty with ignoring (habituating to) tactile sensations, and some patients perceive that this contributes to a “premonitory urge” to tic. While common, the physiological basis of impaired tactile processing in Tourette Syndrome, and indeed tics themselves, remain poorly understood.

It has been well established that GABAergic processing plays an important role in shaping the neurophysiological response to tactile stimulation. Furthermore, there are multiple lines of evidence suggesting that a deficit in GABAergic transmission may contribute to symptoms found in Tourette Syndrome.

In this study, the authors used testing (magnetic resonance spectroscopy) and tasks that were vibrotactile (the perception of vibration through touch) to investigate the role of GABA and atypical sensory processing in these 8-12-year old children with Tourette Syndrome.

They found the following:

  • lower concentration of GABA in the sensorimotor cortex and “impaired performance on tactile detection and adaptation tasks, consistent with altered GABAergic function”
  • the altered/reduced GABAergic function correlated with the severity of motor tics and sensory impairments, “linking the core feature of Tourette Syndrome directly to … brain neurochemistry.”

The authors conclude that this provides a foundation for novel interventions (i.e. medications) but unfortunately do not offer the use of the amino acid GABA as one of these solutions. This is very unfortunate but not unexpected. I plan to reach out to the authors and share this case study and blog.

This research supports why GABA works so well for Kim’s son and why he needed higher amounts of GABA when his tics were more active/severe. And now I’m curious to find out if her son has/had sensory issues and how they improve/improved with GABA. I’ll report back if I hear from her about this.

It’s no surprise that GABA helps his sleep too. There is much evidence supporting this – like the the sleep promoting effects of combined GABA and 5-HTP (or GABA alone or 5-HTP alone).  I’ve also shared many GABA-sleep success stories on the blog. Here is one: Since starting GABA my child sleeps for the first time in years and really notices a difference in his carb cravings. (Use the search feature and “GABA sleep” to find additional blog posts)

Interestingly only 8% of the children in the study had generalized anxiety disorder. Given how common low GABA is in anxiety, and that low serotonin can also be a factor with tics, I would have expected anxiety to be higher.

Evidence supporting the other nutritional changes he made

There is evidence to support the other nutritional changes that Kim’s son made:

  • There are reports that “an increase in tics has been related to the consumption of caffeine and refined sugar.” The authors acknowledge that there is no one diet for Tourette’s, so as always, it’s a matter of figuring out the ideal diet for each child (or adult) with tics. Oligoantigenic diets have been identified as significantly reducing tics. This involves removing foods that can potentially cause a food sensitivity leading to tics and/or behavioral impacts and/or insomnia.
  • A gluten-free diet maintained for one year in patients with Tourette’s Syndrome was shown to markedly reduce tics and OCD in children and adults
  • Magnesium is one of the most used supplements in children with Tourette’s Syndrome. When used with probiotics, omega-3 and multivitamins “Seventy-five per cent of supplement users in the Tourette syndrome group noted improvement, mainly in motor and vocal tics, sleep quality and anxiety reduction.”
  • Melatonin is listed with a number of medications commonly prescribed for tic disorders where sleep issues are also a factor

Keep in mind that the above is not a protocol for relief from tics for everyone with Tourette’s Syndrome. It’s what worked for the unique biochemical needs of Kim’s son.

That said, this could be a framework to start with and build upon.

Tyrosine improves his mood and focus

Tyrosine helps with low catecholamines, improving the curl-up-in-bed low-energy kind of low mood and poor focus. (You can see all the symptoms here.) The typical dose is 500mg tyrosine a few times a day. Kim’s son found just 300mg to be beneficial.

Interestingly, 48% of the children in this study had attention-deficit/hyperactivity disorder (ADHD) with about half of those on stimulant medication. I wonder how many would have also benefited from tyrosine for improving their focus, as it did for Kim’s son.

You can read more about tyrosine for focus and mood, and motivation and energy here.

Resources if you are new to using GABA or tyrosine as a supplement

If you are new to using the the amino acid GABA or tyrosine as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low serotonin and other low neurotransmitter symptoms) and a brief overview here: Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low levels of GABA or catecholamines and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids so you are knowledgeable.

And be sure to share it with the team you or your loved one is working with. As I mentioned above, it’s empowering for your teen and also relatively easy reading too.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the GABA and tyrosine products that I use with my individual clients and those in my group programs.

Have you seen results with GABA or any of the above approaches? Or has another approach helped you or your child?

If you’re a practitioner have you seen GABA and any of the above to help? What else has helped your clients/patients?

If you suffer from Tourette’s Syndrome, do you also experience ADHD, insomnia, low mood and/or anxiety?

Feel free to ask your questions here too.

Does 5-HTP make you “wired-tired” and affect your sleep when cortisol is high? (“yes” and “not sure” and “no, 5-HTP was miraculous!”)

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5-htp and sleep

Both 5-HTP and tryptophan are amino acid supplements that are known to help to boost serotonin levels so you can feel happy, calm, sleep well and not crave carbs in the afternoon/evening. They also help with panic attacks and phobias, lack of confidence, depression, negativity, imposter syndrome, PMS, irritability, anger issues, pain/fibromyalgia, TMJ and anger. I typically have my clients with low serotonin symptoms start with a trial of tryptophan because I see such excellent results with this amino acid. That being said, some people simply do better on one versus the other and you may do better with 5-HTP.

There is one big caveat with 5-HTP. I don’t recommend 5-HTP when a client has elevated cortisol levels because we know that it can raise cortisol levels in certain individuals. This can leave you feeling agitated, cranky, as well as “wired and tired” at the same time. You may be able to relate to this if you’ve ever used 5-HTP to help with anxiety and insomnia and ended up feeling more anxious and more wide-awake despite your exhaustion and need for sleep.

Today you’ll hear actual feedback from members of my community who responded to a past blog post: 5-HTP can raise salivary cortisol: does this cause a “wired-tired” feeling?.

Read on to hear how one woman found that 5-HTP did lead to her feeling wired and tired and how 5-HTP made sleep worse and worse in another; how one woman wasn’t sure if 5-HTP caused her disturbed sleep and waking in the night; and how one man found that 5-HTP was miraculous for his wife.  In each instance I offer input and next steps if necessary.  As you can see their responses were very different and my hope is that you may see yourself in some of these “cases” and learn more about using the amino acids.

And be sure to read the original blog post if you’d like to check out the study and some of my feedback on it and using 5-HTP.

5-HTP did lead to feeling wired and tired and made sleep worse and worse

Gloria shared  how 5-HTP did not help her sleep and made her feel wired and tired. She figured out the tryptophan did work for her:

I so appreciate your blog and have learned so much that is helpful. I tried 5-HTP and it did not help me sleep. I do much better on Lidtke tryptophan. The 5-HTP did make me feel wired and tired. I also have that reaction to GABA Calm because of the taurine and do much better on GABA-T SAP. Thank you for all your research.

I appreciate her sharing and am so pleased she has good results with tryptophan. The Lidtke brand is the one I have the most success with. The GABA-T SAP is a combination of GABA and theanine and is another product I recommend and see good results with.

Alexandra knew she had high night time cortisol and yet has been taking 5-HTP at the recommendation of her psychiatrist and her sleep was getting worse and worse. She shared this on the above blog post:

Your posts do not stop amazing me! I have been diagnosed with HPA axis dysfunction with high cortisol at night, my psychiatrist had me on 200 mg of 5-HTP and my sleep was getting worse and worse! I had to stop taking it because I was going to get the DUTCH test done by Geneva and noticed I slept much better without it…. I am so grateful for your posts!

I appreciate her for sharing and glad she made the connection. Hopefully she shared this information with her doctor too.

The 200mg 5-HTP dose is considered relatively high, certainly as a starting dose. I start clients on 50mg and increase based on symptoms so I assume she worked up to taking 200mg.

When 5-HTP is making things worse we switch to tryptophan, also starting low and increasing based on need. Keep in mind that 50mg 5-HTP is equivalent to 500mg tryptophan but I like to have clients start low when making a switch and increase based on results.

It’s always important to address the high cortisol levels (with Seriphos and other adrenal support). And to consider checking for parasites, changes in sex hormones, SIBO (small intestinal bacterial overgrowth), gluten issues and other food intolerances, toxin exposure, new EMF exposure, medication side-effects, mold toxicity and infections – all of which can affect sleep and may impact cortisol levels.

Not sure if 5-HTP caused disturbed sleep and waking in the night

Merrily experienced some really good results using 5-HTP, starting low and working up to her ideal dose of 200mg. And then she started experiencing disturbed sleep and wasn’t sure if it was the 5-HTP:

Because of mood issues – dysthymia [low mood], irritability, negative thoughts, and low energy, my doctor recommended 5-HTP. I started on 50mg 5-HTP and have worked up to 200mg daily (which I’ve been taking at bedtime for over 2 years now). On the occasions when I cut back, mood issues returned which does suggest to me it’s working.

Lately I am experiencing problems with disturbed sleep, waking during the night which I had not associated with the 5-HTP. Shall I switch to tryptophan?

Thank you so much for your blogs, your book and lectures. You really make a difference Trudy!

She has a few options. One is to cut back the 5-HTP again and see if her mood issues return. If they don’t return and sleep improves she can stay on the lower dose but may need to increase it temporarily during the winter time

Another option is to space out her dosing and take less at night and some mid-afternoon.

Finally she could switch to tryptophan. As I mentioned above, 50mg 5-HTP is equivalent to 500mg tryptophan but I like to have clients start low when making a switch and increase based on results.

If these approaches don’t work it would be useful to test salivary cortisol levels to see if her cortisol levels are now high and if yes, address this with Seriphos and other adrenal support as I mentioned for Alexandra above. And to consider checking the same root causes that can affect sleep and cause high cortisol levels.

No, 5-HTP was miraculous for his wife!

When serotonin levels are low and cortisol is not high, results with 5-HTP can be miraculous for some individuals. Russell shared how much his wife benefitted from just 50mg 5-HTP twice a day:

I treated my wife with 5-HTP when she suffered from work burn out, depression and menopause. This all hit at once.

I spent hours researching what I could to relieve the night sweats, mood swings etc. and came upon 5-HTP. I used 50 mg 5-HTP, one before bedtime and the other on waking up and it basically fixed everything that was associated with the problems mentioned above.It was miraculous to say the least and my wife was also very happy.

I’m thrilled for his wife and thanked him for sharing the wonderful results she has experienced with 5-HTP.

If her results were not sustained, I’d suggest taking her doses mid-afternoon and before bed as this is when serotonin is lowest. Otherwise, I’d say continue as above.

Keep in mind that 50mg 5-HTP twice a day is a typical starting dose and we increase from there. In her case, this was sufficient and she did not need to increase her dose or take additional doses during the day.

Positive research and positive case studies

My intention is not to scare you away from doing a trial of 5-HTP if you have low serotonin symptoms, but rather to educate. As with all nutritional approaches, there is no one-size-fits-all so we just need to be smart with using amino acids.

There are also many studies supporting the serotonin-boosting effects of 5-HTP:

These blog posts illustrate other positive case studies where 5-HTP was extremely beneficial:

I see wonderful results like this all the time, but always keep the high cortisol and “wired and tired” potential issues in the back of my mind.

Unfortunately many practitioners only ever recommend 5-HTP due to their concerns about tryptophan.

Resources if you are new to using 5-HTP (or tryptophan) as a supplement

If you are new to using the the amino acid 5-HTP (or tryptophan) as a supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low serotonin and other low neurotransmitter symptoms) and a brief overview here: Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low levels of serotonin and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids so you are knowledgeable. And be sure to share it with the team you or your loved one is working with.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the 5-HTP and tryptophan products that I use with my individual clients and those in my group programs.

Have you used 5-HTP with success? Or have you used it and felt “wired-tired” with an impact on your sleep? Have you correlated the success or failure of your 5-HTP use with your salivary cortisol levels?

What approaches have you used to lower your cortisol levels?

If you switched from 5-HTP to tryptophan did you have success with that?

If you’re a practitioner is this something you see with your clients/patients and take into consideration?

Feel free to ask your questions here too.

The seasonality of GABA: worsening anxiety, insomnia and intrusive thoughts in winter (and the need for increased GABA supplementation)

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seasonability of gaba

Seasonal variations in serotonin have long been documented with much research on the winter blues and SAD lamps. There is less awareness about GABA seasonality and I only recently started to look into the research when I wrote about the need to increase tryptophan or 5-HTP temporarily when a winter dip in serotonin causes more severe anxiety, OCD and/or the winter blues.

Following on from my blog post on the seasonality of serotonin, it’s important to be aware of the seasonality of GABA and that GABA levels may also be lower in the winter months. This is also due to shorter days and less light because of more overcast and cloudy/rainy/snowy days.

You may find you need to increase your GABA supplement dosing during this time, in order to get the same benefits for your low GABA physical anxiety, stiff and tense muscles, insomnia (the low GABA lying-awake-tense type), feelings of overwhelm, intrusive thoughts (the low-GABA type), and stress-eating or self-medicating with alcohol.

Read on to learn more about seasonal fluctuations in GABA, an example of how adjusting GABA could look and some of the possible mechanisms.

Intuitively increased GABA without knowing about the seasonality of GABA

A few weeks ago I shared on Facebook that GABA has a seasonal aspect and an increase may be needed in winter when it’s darker earlier and colder. Elicia offered this input:.

I use GABA Calm and usually take 1 or 2 a day. The past two days I’ve taken 4 because I suspected that I needed an increase.

I take it for physical anxiety, insomnia and intrusive thoughts. My symptoms had been worsening recently. The increased GABA seems to be helping.

She also asked what an increase in GABA would look like.

My feedback for her is (you guessed it!) that it depends on each person. If 4 x instead of 1 or 2 x GABA Calm a day helps to ease her symptoms then that’s the right amount for her unique needs at this time. It may be less or more for someone else. And it’s going to change again after the winter season.

I’m so glad to hear she intuitively increased her dose without knowing about the seasonality of GABA and that she saw her worsening symptoms improve.

Other approaches to boost GABA levels may help too: Yoga, meditation, tai chi and essential oils.

Seasonal fluctuations are also found in anxiety disorders and bulimia nervosa

As I mentioned above, SAD or seasonal affective disorder, appears to be relatively common and is well-recognized.

This review paper, An overview of epidemiological studies on seasonal affective disorder mentions anxiety and other conditions too:

  • Seasonal variations in mood, depressive symptoms usually peaking in winter
  • SAD was more prevalent at higher northern latitudes, but the prevalence varied across ethnic groups.
  • SAD has also been identified in children and adolescents.
  • Seasonal exacerbations and remissions are not limited to mood disorders, it has also been found in bulimia nervosa, anxiety disorders and other psychiatric illnesses.

Some of this may be related to low serotonin and as you’ll see below, melatonin and low GABA (and low dopamine too), and the liver, all may play a role too.

GABA is higher in summer/lower in winter and tied to liver function

In this animal study, Effect of the pineal gland on 5-hydroxytryptamine and γ-aminobutyric acid secretion in the hippocampus of male rats during the summer and winter, they report that

GABA secretion in the hippocampus of rats had a seasonal rhythm consisting of increased secretion in summer and decreased secretion in the winter.

Additionally, the liver can regulate the content of active substances, including GABA, and its function is controlled by brain centers, especially in the marginal lobe.

This paper reports similar seasonal changes with respect to serotonin, stating that both fluctuations may be related to the seasonal changes of “regulation by the liver”. The authors remind us that in Chinese Medicine the liver is closely related to emotions, and that the liver functions well in hot weather and is weak in winter.

GABA exhibits seasonal rhythms related to the pineal gland and melatonin

The introduction of this animal study (by the same authors), Molecular mechanisms of seasonal photoperiod effects of the pineal gland on the hippocampus in rats highlights a number of points related to seasonal variations in mood:

Based on the theory of “five Zang-organs corresponding to the seasons” in traditional Chinese medicine (TCM), physiological functions including emotions vary with the seasons.

The production of mood-related neurotransmitters such as 5-hydroxytryptamine [serotonin], γ-aminobutyric acid [GABA], dopamine, and norepinephrine exhibits seasonal rhythms, which are related to the regulation of the hippocampus by the pineal gland-MT [melatonin] system.

In other words, GABA (and these other neurotransmitters) exhibit seasonal rhythms related to melatonin secreted by the pineal gland, thereby impacting the hippocampus.

Be sure to read the paper for additional information on depression, seasonal affective disorder and bright light therapy; the seasonal effects of the pineal gland on the hippocampus; the role of melatonin and photoperiod/length of night; the hippocampus and melatonin receptors and more.

The authors were looking for direct evidence of the signalling mechanisms that cause this to happen:

Our findings suggest that the MTR-Gs/Gi-cAMP-PKA-CREB signaling pathway is involved in the seasonal photoperiod [length of night] effects of the pineal gland on the hippocampus and may underpin seasonal changes in emotions.

Feel free to read more about all this in the paper too as it’s beyond the topic of this blog.

Other factors to consider: sugar/alcohol, stress/pyroluria and low serotonin

I’d also consider the following:

  • The increased consumption of sugar at this time can lead to reduced zinc, magnesium and B vitamins (like vitamin B6 and thiamine) and this can further reduce GABA levels, which relies on these nutrients as cofactors for production. By boosting GABA levels with the amino acid GABA (and higher amounts if needed) you can actually reduce some of the cravings and stress-eating.
  • Overindulging in alcoholic holiday beverages can also deplete zinc and B vitamins, further affecting GABA production. Using higher amounts of the amino acid GABA (if needed) can also prevent self-medicating with alcohol. This often happens when trying to fit in and socialize.
  • If you have the social anxiety condition called pyroluria, the added stress of family and holiday gatherings can also contribute to zinc and vitamin B6 being dumped, and further impacting serotonin production.
  • The need to also increase tryptophan or 5-HTP temporarily when a winter dip in serotonin causes more severe anxiety (the low serotonin worry-type), OCD and/or the winter blues.

Resources if you are new to using GABA as a supplement

If you are new to using the the amino acid GABA as a supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low GABA and other low neurotransmitter symptoms) and a brief overview here: Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low levels of GABA and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids so you are knowledgeable. And be sure to share it with the team you or your loved one is working with.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the GABA products that I use with my individual clients and those in my group programs.

Have you noticed worsening anxiety, insomnia, intrusive thoughts or even bulimia in the winter months?

Have you noticed you need more GABA in the winter? And then you ease off at the end of winter again?

What changes in your dosing have made a difference with your symptoms?

Did you adjust intuitively or were you aware of the GABA seasonality aspect?

And do you notice something similar with serotonin support and needing additional melatonin in winter too (if you already use it)?

If you’re a practitioner, do you have your clients/patients make adjustments too?

Feel free to ask your questions here too.

Trigeminal neuralgia and anxiety: GABA, tryptophan, St. John’s Wort, acupuncture, DPA, gluten, herpes and Lyme disease

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trigeminal neuralgia and anxiety

I get a surprisingly high number of questions about trigeminal neuralgia asking if there is a role for the amino acids GABA or tryptophan to help ease some of the nerve and associated face pain. It’s surprising because trigeminal neuralgia is considered a rare neurological disorder.

Nerve pain is not my area of expertise (anxiety is), and because anxiety and depression is common in this population, there are very likely similar underlying causes (more on that below). The targeted individual amino acids that we use for anxiety, also help to ease pain, so I’m sharing some of what I know in case it helps you or a loved one.

Read on to learn more about this condition and GABA, tryptophan, DPA, acupuncture, St. John’s Wort, Lyme disease, herpes and B vitamins.

About trigeminal neuralgia and the incidence

The NIH fact sheet defines trigeminal neuralgia (TN) as

a chronic pain condition that affects the trigeminal or 5th cranial nerve, one of the most widely distributed nerves in the head. TN is a form of neuropathic pain (pain associated with nerve injury or nerve lesion.) The typical or “classic” form of the disorder (called “Type 1” or TN1) causes extreme, sporadic, sudden burning or shock-like facial pain that lasts anywhere from a few seconds to as long as two minutes per episode.  These attacks can occur in quick succession, in volleys lasting as long as two hours.  The “atypical” form of the disorder (called “Type 2” or TN2), is characterized by constant aching, burning, stabbing pain of somewhat lower intensity than Type 1.  Both forms of pain may occur in the same person, sometimes at the same time. The intensity of pain can be physically and mentally incapacitating.

The incidence of new cases is approximately 12 per 100,000 people per year and women are impacted more than men.

A number of studies show anxiety, depression and insomnia are common when someone has trigeminal neuralgia. The question is this – is the pain causing the anxiety, depression and insomnia OR are there common underlying physiological causes for both. It’s likely a combination of both especially when it comes to idiopathic trigeminal neuralgia i.e. when there is no known cause. Known causes include head injury, multiple sclerosis, dental procedures, tumors and cysts.

By using some of the approaches outlined below, we may see pain relief and improved mood, less severe anxiety and better sleep.

When to consider GABA and serotonin support

There is no research on either GABA or tryptophan/5-HTP helping with symptoms of trigeminal neuralgia, however medications that work on both GABA and serotonin are typically prescribed for trigeminal nerve pain. For this reason I would consider a trial of GABA and/or tryptophan (or 5-HTP if other low GABA physical anxiety symptoms and low serotonin worry-type anxiety symptoms are also present. You can find the symptoms list here.

There is research-based and clinical evidence that GABA and serotonin support help with other types of pain:

Both help with the anxiety, low mood and insomnia that is often present with pain conditions like this.

St. John’s Wort for nerve pain and mood

In one case report, Hypericum perforatum (St. John’s Wort) as a possible therapeutic alternative for the management of trigeminal neuralgia (TN), a 53-year-old Hispanic female patient with a history of trigeminal neuralgia used an over-the-counter preparation of St. John’s Wort and found it relieved her pain completely.

St. John’s Wort is a herb that is primarily “used for depression but also is used for rheumatism, gastroenteritis, headache and neuralgias. ” This case report is one of many studies on this herb and trigeminal neuralgia and other neuralgias (nerve pain).

It has anti-inflammatory and antioxidant effects and also supports serotonin and GABA production which further supports the above recommendations to trial the amino acids.  GABA and tryptophan would also be safe options if St. John’s Wort can’t be used as in the case of blood thinners, the birth control pill and other medications

Pain relief with endorphin support: acupuncture and DPA

Acupuncture offers pain relief via endorphin boosting and can be an option for the treatment of  trigeminal neuralgia, also offering relief for the “secondary myofascial pain associated with it.”

DPA (d-phenylalanine) is an endorphin-boosting amino acid that may also offer some pain relief. It can also be used to wean off prescription pain medication and improve sleep.

Other research-based pain-relief approaches for trigeminal neuralgia

Physical therapy, chiropractic care, using a custom dental appliance, and addressing myofacial pain may offer relief or be part of the solution.

There are some less recognized approaches too:

All of the above can also improve mood and insomnia and reduce anxiety too.

Other factors to consider: B vitamins, Lyme disease, herpes and gluten

As with any condition, a full functional medicine work up should be done to rule out and/or address gluten issues, low vitamin B6/B1/B12, and even herpes zoster and Lyme disease as a root cause (or contributing factor).

Current approaches and emerging interventions – disappointing for a 2021 paper

I was excited to read the title of this paper, Trigeminal Neuralgia: Current Approaches and Emerging Interventions, published late this year. The authors share that it “summarizes over 150 years of collective clinical experience in the medical and surgical treatment of trigeminal neuralgia.”

What is disappointing is there is no mention of any of the approaches listed in this blog. It’s published by neurosurgeons so it is understandable that they would say: “The first-line treatment remains anticonvulsant medical therapy. Patients who fail this have a range of surgical options available to them.”

Medications and/or surgical options may work well for you but if not, you need to know there are other options. You may also be looking for a medication-free or non-invasive approach.

Keep in mind that this is what you’ll be offered unless you work with a functional medicine practitioner.

I do agree with and am encouraged by these statements:

  • What is increasingly clear is that there is no catch-all medical intervention that is effective for all patients with trigeminal neuralgia, likely reflective of the fact that it is likely a heterogenous group of disorders that jointly manifests in facial pain.
  • Ultimately, elucidation of the molecular mechanisms underlying trigeminal neuralgia will pave the way for novel, more effective and less invasive therapies.

Complementary approaches: NIH fact sheet

What is encouraging is that the NIH fact sheet I link to above, does mention low-impact exercise, yoga, creative visualization, aromatherapy and meditation.

Other than the standard medications (carbamazepine, oxcarbazepine, topiramate, gabapentin, pregabalin, clonazepam, phenytoin, lamotrigine and valproic acid and tricyclic antidepressants such as amitriptyline or nortriptyline) and surgical options they do also mention acupuncture, chiropractic, biofeedback and nutrients.

Botox is listed too but I have concerns about this approach.

This blog is not intended to be a comprehensive approach for pain relief for trigeminal neuralgia but rather some options you can consider and explore with your practitioner – especially when you also have anxiety, depression and insomnia too.

Resources if you are new to using tryptophan/5-HTP, GABA and DPA as supplements

If you are new to using the amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low serotonin, low GABA and low endorphin symptoms) and a brief overview here: Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids so you are knowledgeable. And be sure to share it with the team you or your loved one is working with.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acid products that I use with my individual clients and those in my group programs.

Has any of the above approaches helped you or your loved one? If not, what has helped you?

What conventional treatment have you had and did it help? Were you offered any of the above non-medication and non-surgical treatment approaches?

If you’re a practitioner, has any of this helped? Please share your treatment approaches too.

Feel free to ask your questions here too.

Increasing tryptophan or 5-HTP temporarily when a winter dip in serotonin causes more severe anxiety, OCD and/or the winter blues

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tryptophan and 5htp during winter

Don’t forget that serotonin takes a dip in winter when the days are shorter and there is less light. If you’re currently using tryptophan or 5-HTP to boost low serotonin and ease low serotonin symptoms – worry-type anxiety, panic attacks, insomnia, ruminations, PMS, irritability, negativity, perfectionism, obsessiveness, lack of confidence, anger/rage, afternoon/evening cravings – you may find you need to increase your dose for a few months.

This will especially be the case if you check off winter blues or more severe winter anxiety (yes it’s a thing and published in the research) on the low serotonin symptoms list.

I shared this on Facebook last week and the feedback ranged from surprised to curious to confirmatory.

In this blog I’m sharing some of the feedback and some of the supporting evidence, as well as other factors to consider.

The addition of 5-HTP in the morning and a light box

Kathy thanked me for the reminder and shared the changes she makes in the winter months:

Thanks for the reminder! I need to increase my dose this time of year… I can feel myself feeling “down”. I take 500 mg Tryptophan before bed and 100 mg 5-HTP in the morning before breakfast. I also use a light box in the morning while eating breakfast, which helps.

This is an increase from her typical dosing in the spring and summer when she only takes tryptophan at night before bed.

She also only uses her light box or SAD (seasonal affective disorder) lamp in winter. You can read more about SAD/full spectrum lamps here. They are also a wonderful way to boost serotonin and mood in the winter.

My daughter’s anxiety and OCD goes through the roof

Mark shared about his daughter’s anxiety and OCD (obsessive compulsive disorder):

Every year from October – March, my daughter’s anxiety and OCD goes through the roof. At first we thought it was the transition from summer to school, then the craziness of the winter holidays and suspected mold allergy. Now, based on this information, a winter/less light induced dip in serotonin may be an additional factor we hadn’t considered. We’ll try adjusting her 5-HTP dose and see if we gain some improvement. Thanks for the tip.

It’s really common for families to attribute the more severe anxiety and OCD to the stress and craziness of the winter holidays. And of course suspected mold issues do need to be looked into and addressed. But even then, the dip in serotonin can compound all these factors.

Planned tryptophan bump for Christmas sugar cravings and holiday family stress

Carol shared this about her plans to temporarily boost serotonin:

I am one of those light weights that was able to do one 500 mg pill a day of tryptophan. But I do think that it would help to bump it up to two a day to get me through the Christmas sugar cravings AND holiday family stressful get togethers! I’m all about taking the minimum effective dose but this is helpful to know that there could be a temporary boost just to get you through this time!

It’s wonderful that 500mg tryptophan is enough for her and I’m all for a minimum effective dose! However the winter dip in serotonin – and increased sugar cravings and family stress – is a common reason many folks bump up the dose for a month or more.

You may also find you made the change intuitively. Linda shared this: “I had made the adjustment. I just did not realize the reason why.”

A question about timing of 5-HTP and what to do in Spring

Suzanne shared that she uses a SAD light (also called a light box) and finds that it helps. She asks:

Can I just take the 5-HTP on days with no sun or is it better to have it build up in my system? When spring rolls around, do I taper off or can I just stop taking it?

This is my feedback: I haven’t had anyone just use 5-HTP on cloudy days but it’s worth a trial.  If you are noticing increased anxiety and mood changes only on cloudy days and using the SAD lamp on those days helps, then using 5-HTP on those days may be enough. If not, use 5-HTP consistently/daily through the winter months.

Amino acids do not need to be tapered but I find my clients do better when they are reduced over a few weeks. Some folks also choose to just stop taking them and do fine.

I appreciate all the feedback and the great questions. I’ll report back when I hear how Mark’s daughter does with the adjusted 5-HTP and how Carol does with the bump in tryptophan (and any other feedback I get from these folks).

Some of the research and possible mechanisms

There are many studies that support serotonin changes and seasonal variations in mood. Here are just two of them:

  • Effect of sunlight and season on serotonin turnover in the brain “Alterations in monoaminergic neurotransmission in the brain are thought to underlie seasonal variations in mood, behaviour, and affective disorders… turnover of serotonin by the brain was lowest in winter. Moreover, the rate of production of serotonin by the brain was directly related to the prevailing duration of bright sunlight… Our findings are further evidence for the notion that changes in release of serotonin by the brain underlie mood seasonality and seasonal affective disorder.”
  • Sunshine, Serotonin, and Skin: A Partial Explanation for Seasonal Patterns in Psychopathology? “one contributory facet may be the role of sunshine on human skin. Human skin has an inherent serotonergic system that appears capable of generating serotonin.”

Other factors to consider: low vitamin D, sugar, pyroluria and phenols

There are other low-serotonin related factors to consider too:

  • Low vitamin D is common in the winter and sufficient levels are needed for making serotonin. This paper, Vitamin D and the omega-3 fatty acids control serotonin synthesis and action, part 2: relevance for ADHD, bipolar disorder, schizophrenia, and impulsive behavior describes how“Brain serotonin is synthesized from tryptophan by tryptophan hydroxylase 2, which is transcriptionally activated by vitamin D hormone. Inadequate levels of vitamin D (∼70% of the population) and omega-3 fatty acids are common, suggesting that brain serotonin synthesis is not optimal.”
  • The increased consumption of sugar at this time can lead to reduced zinc, magnesium and B vitamins (like vitamin B6 and thiamine) and this can further reduce serotonin levels, which relies on these nutrients as cofactors for production. By boosting serotonin with additional tryptophan or 5-HTP you can actually reduce some of the cravings.
  • If you have the social anxiety condition called pyroluria, the added stress of family and holiday gatherings can also contribute to zinc and vitamin B6 being dumped, and further impacting serotonin production.
  • Christmas tree phenols can be a trigger for anger, meltdowns, anxiety, hyperactivity, insomnia, aggression, self-injury and autistic symptoms in susceptible individuals

Resources if you are new to using tryptophan and 5-HTP as supplements

If you are new to using the amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low serotonin symptoms here) and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low serotonin or low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids so you are knowledgeable. And be sure to share it with the team you or your loved one is working with.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acid products that I use with my individual clients and those in my group programs.

Have you noticed this winter dip in serotonin and made adjustments to your 5-HTP or tryptophan? And do you feel less anxious, less obsessive, not as low and with fewer sugar cravings?

Do you find that using a SAD lamp/full spectrum light at this time helps even further?

Were you aware that serotonin dipped in winter and could be playing a role for you? Or did you think it was just the stress and overwhelm of the holidays (and /or some of the emotional upheaval some of us face at this time)?

If you’re a practitioner, have you seen this with clients or patients?

Have you also noticed you need to adjust your GABA and other amino acids at this time too (both GABA and dopamine show seasonality)?

Feel free to ask your questions here too.

Around my period I definitely feel the need for extra tryptophan if I’ve had some extra heavy emotional stuff come up that I need to process

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period and extra tryptophan

Many women find that they need additional nutritional support i.e. tryptophan for serotonin support (and often GABA too) around their periods. Today’s case study highlights the hormonal shifts that may lead to a situation where it appears tryptophan doesn’t work, then it does work, and then sometimes it doesn’t work as expected. The variable results and the need to switch between lower and higher doses on an ongoing basis can occur with PMS (premenstrual syndrome) PMDD (premenstrual dysphoric disorder, a severe, sometimes disabling extension of premenstrual syndrome). The variable results can also be more pronounced while recovering from trauma.

This case study is a follow-on from a blog I recently published: Tryptophan doesn’t work, then it does and then it doesn’t: could it be hormonal shifts, dietary factors and/or parasites?

Here is Kimberley’s feedback on the Facebook post that discussed these variable results. She shared how her hormonal shifts led to a need for additional tryptophan and 5-HTP:

Around my period I definitely feel the need for extra tryptophan. My PMDD symptoms have decreased since I started using tryptophan/5-HTP, but sometimes I need a bit more if I’ve had some extra heavy emotional stuff come up that I need to process (since that always happens with my period!).

I thanked her for sharing and said how happy I was for her. I also asked what symptoms have decreased and how much? I also asked how much tryptophan and 5-HTP she uses before her period and then around her period?

I was also curious if she just experimented with different doses until she figured it out or had she heard me talk about the PMDD tryptophan study: A placebo-controlled clinical trial of L-tryptophan in premenstrual dysphoria. In this study tryptophan was found to reduce symptoms of PMS when used in the luteal phase or second half of the cycle (i.e. after ovulation).

Her low serotonin symptoms have decreased as much as 75-80 percent

Kimberley confirmed that she had read the above study and related blog post – Tryptophan for PMS: premenstrual dysphoria, mood swings, tension, and irritability – and more about her symptoms:

I had read the blog you referenced, which is one of the reasons I tried tryptophan in the first place.

I was experiencing a lot of emotional distress, feelings of downright despair that left me miserable both during my period and ovulation (half the month, every month, which was truly awful). Those have definitely decreased, sometimes as much as 75-80 percent, other times they’re worse and I feel like I need more support.

I usually take 1x Lidtke 5-HTP (50mg) mid-afternoon and 1x Lidtke Tryptophan (500mg) at bedtime, but yesterday I increased to 2x Lidtke Tryptophan and do feel an improvement in my mood this morning.

I experimented to get the right dose of both amino acids, initially increasing to the maximum you recommend, and then slowly decreasing to what I’m taking now when I found I didn’t feel well when I took too much.

I just reread the blog you linked above and realized I should be using GABA every day to support progesterone (instead of just as needed for anxiety). Thanks for the reminder!

I love that after reading the blog she was inspired and motivated to experiment with different doses when she is/was feeling so bad. I encouraged her to continue trialing different doses at various times of the month especially in the second half of the month. I also reminded her that some folks do better with tryptophan and some do better with 5-HTP when it comes to low serotonin symptoms. And to continue to look at why serotonin is low and address that. Low GABA (related to low progesterone) can cause increased anxiety at this time and is a common issue with PMS/PMDD.

(You can see the entire list of low serotonin and low GABA symptoms here.)

She plans to continue experimenting with tryptophan and 5-HTP and may also try switching over to just 5-HTP and see if that changes anything. It’s unlikely that she would benefit from much higher doses of either as she shared “I don’t seem to be able to take more than 2 caps of either one without getting uncomfortable symptoms, though.”

Exercise and yoga for her low serotonin and PMDD

She did share how much exercise helps her mood, why she isn’t able to exercise as much:

The biggest thing I know to do to address low serotonin is add more exercise into my life, but this has been hard lately because I’ve had a couple of different viruses recently that left my exercise intolerance worse than it had been. I’m trying to support my mitochondria right now and add light exercise back in slowly.

Exercise is a wonderful way to raise serotonin levels and aerobic exercise has been shown to reduce the symptoms of PMS too. Yoga may be an option while she is recovering. In one study, yoga was found to be beneficial for PMS: “Alpha-brain waves production due to regular yoga practice are directly related with state of peace, creativity, mood elevation, relaxation, and release of serotonin, thus leading yoga practitioners feel more relaxed.”

Trauma: cortisol, serotonin, dopamine and estradiol

Kimberley also shared how how trauma plays into her situation:

I think some of the reasons for my health issues, low neurotransmitters, etc., are trauma related and I’ve been working through Dr. Aimie Apigian’s programs for that. But that’s another story.

I respect Dr. Aimie Apigian’s work in trauma and somatic experiencing and acknowledge this aspect must be addressed too. I love that Dr. Aimie brings this together with a functional medicine approach, looking at biology/biochemistry too. Recent trauma research confirms that there are major biochemical mechanisms involved in PTSD (post-traumatic stress disorder). These can include impacts to cortisol, serotonin and dopamine levels. And women are more vulnerable to these effects.

A 2021 paper, Estradiol, stress reactivity, and daily affective experiences in trauma-exposed women discusses high cortisol and more severe symptoms around their periods when estradiol (one of the estrogens) is low. As I mentioned above, estrogen and serotonin are closely related. The authors state this:“For women who are cycling, it may be useful to understand how the menstrual cycle affects their symptoms. When you can explain what’s happening biologically, it often becomes less threatening.”

Yoga may provide added psychological benefits as she works through her past trauma too.

Kimberly gave me permission to share her story and this is always something I appreciate so others in my community can learn from these types of experiences. If needed, I hope this her story gives you confidence to experiment with different doses and combinations around your period.

She also benefits from the comments from others on Facebook and the comments here on the blog, our back and forth, and this blog post.

She promised to keep me posted on how she goes and I’ll be sure to share when I hear back from her.

Resources if you are new to using tryptophan, 5-HTP and GABA and the amino acids as supplements

If you are new to using the amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low GABA symptoms here) and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low GABA or low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids so you are knowledgeable. And be sure to share it with the team you or your loved one is working with.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acid products that I use with my individual clients and those in my group programs.

Have you found you need additional tryptophan/5-HTP or GABA around your period? How have you experimented and how does it help you?

If you’re a practitioner, have you seen this with clients or patients?

Do you also feel better with exercise and/or yoga?

And are/were your variable results more pronounced while recovering from trauma?

Feel free to ask your questions here too.