Archives for August 2022

Rebound insomnia after tapering a benzodiazepine: will taking GABA or any other natural supplement interfere with healing?

August 26, 2022 By Trudy Scott 16 Comments

This question was posted on one of the GABA blog posts by Fran, asking about about using GABA for insomnia shortly after having tapered a benzodiazepine she had used for 15 years:

I am a senior who took benzodiazepines (clonazepam) on advice of my doctor for sleep because of chronic fatigue for 15 years. Last year I weaned myself off the medication and it has been just over 10 months. No one tells you that when you stop taking them you go into a rebound insomnia phase and it can last a long time. The doctor still won’t admit that!

I joined benzo buddies, a group I found out about on your site and found much encouragement from the posts of many brave and determined people. One post mentioned that the drug actually overrides your GABA receptors so when you stop taking it they have to heal to become active again. My question is: Will taking GABA or any other natural supplement interfere with that healing. The writer of the post feels taking nothing is best for the brain to return to normal and that only time will do that.

I said I was sorry to hear about her struggles with her benzodiazepine prescription. Sadly it’s all too common and it’s seldom that folks are cautioned about the rebound insomnia and other issues seen with benzodiazepines.

I love benzo buddies and other benzo support groups and often recommend that clients join one of these groups for the community support aspect. I am really happy that Fran found encouragement.

However, I respectfully disagree with their message that GABA supplements or other supplements should not be used and that you should just wait for time to heal. We want to use everything at our disposal in order to heal as quickly as possible. And quality sleep is imperative for healing.

Also many of the most severely affected folks are part of these support groups, so it may well be all that they know, hence the advice they dispense.

Many do get relief with GABA during and post benzo taper and it won’t affect long-term healing (with a very low dose)

It is true that GABA receptors can be affected by benzodiazepines but despite this, many of my clients and others in my community do get relief from GABA during this period. Since we are all unique, some folks may have an issue, so we always do a trial with GABA if someone has rebound insomnia (and other low GABA symptoms of physical tension/anxiety, stiff and tense muscles, stress eating etc).

When someone can’t tolerate GABA they will know very quickly – typically in 1-2 days. If you can’t tolerate GABA it may feel the same as someone who takes GABA and doesn’t need it (i.e. GABA isn’t low) or when someone takes too much. This could make you feel light-headed, dizzy, feel a flush and/or feel too tired. You may even feel more anxious. Vitamin C is a wonderful antidote to all this and these short-term adverse reactions won’t interfere with long-term healing.

We also start with a very small dose – I typically have someone start with 25mg GABA and go up from there – and only use sublingual GABA. For some very sensitive folks we will start even lower as in this example where Syd gets sleep and body anxiety benefits with just 1.5 mg to 3 mg GABA.

Other nutrients that may also help with insomnia

We may also use other nutrients to help with sleep support and rebound anxiety (which is also common) and other symptoms, all based on each person’s unique needs. These may include tryptophan or 5-HTP if serotonin is also low (this can affect sleep and cause worry/ruminating type anxiety), melatonin if that is low (either sublingual or timed-release) and Seriphos if cortisol is high too. We may also combine GABA with theanine (research shows the combination may help some folks).

A full functional medicine and nutritional workup is recommended in order to be as nutritionally stable as possible. Ideally this happens before tapering starts but even if it’s done after the fact it can help with healing and symptom relief. Addressing histamine imbalances is one factor to consider as this can impact sleep (more on that below).

This is an important question that many folks ask so I appreciate her asking so I could share it as a blog post for others in a similar situation.

I am waiting to hear back about what happened when she did use GABA and how much she used. She mentioned that she did take GABA for a time at first but it only worked for a while. I find that during the taper and post taper, GABA needs can fluctuate as healing starts to take place. I have clients adjust up and down as needed.

More on benzodiazepine withdrawal and histamine issues

These medications have the most debilitating withdrawal reactions in all of medicine and Valium blocks DAO/impacts histamine levels:

World Benzodiazepine Awareness Day 2017: Awareness and Anxiety Nutrition Solutions

Benzodiazepines (Xanax, Klonopin, Ativan, Valium, Librium, and others) as well as Z-drugs (Ambien, Lunesta and others), which are similar, have the most debilitating withdrawal reactions in all of medicine.

This happens in regular, everyday people who are taking the medications exactly as their doctor prescribed. It also happens to people on what they think are “low doses” and is not just a “high dose” problem.

The benzodiazepine valium blocks DAO and impacts histamine levels: wisdom from Yasmina Ykelenstam and a tribute to her brilliance

Many people doing a benzodiazepine taper are often switched to Valium which is a DAO [diamine oxidase blocker (or histamine liberator)] and this further prevents histamine from being removed from the body [and can lead to increased anxiety].

Dyes are also triggers…the pink Xanax can be problematic.

GABA is as effective as benzodiazepines (which should only be prescribed for short-term use)

Many folks who have used benzos in the past, find GABA to be as effective. Another woman in my community, Dee, shared that she had taken Xanax in the past for panic attacks and her functional medicine doctor suggested GABA Calm as she wanted a natural product. This is her encouraging feedback: “I was amazed how it works just like the Xanax did – instant calm feeling within 10 mins of taking 2 capsules. I use them as needed when I am having heightened stress and anxiety.”

Ideally we want to use GABA instead of one of the benzodiazepines – which are all too commonly prescribed for anxiety, insomnia and pain – in order to avoid tolerance issues, dependence and withdrawal/tapering issues. The fact that they are used long term – like 15 years for Fran – further compounds the issues. Even a few months can be problematic for some folks. It’s important to be aware that this class of medication is intended for short-term use i.e. 2-4 weeks only.

Resources if you are new to using the GABA and other amino acids as supplements

If you are new to using GABA and any of other the amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low GABA).

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 on your own so you are knowledgeable. And be sure to share it with the practitioner/health team you or your loved one is working with.

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, self-medicating with alcohol and more.

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 acids that I use with my individual clients and those in my group programs. You can find them all in my online store.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms). This is a paid online/virtual group program where you get my guidance and community support.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. This is also a paid online/virtual program with an opportunity to interact with me and other practitioners who are also using the amino acids.

Have you used GABA with success while tapering a benzodiazepine or shortly after tapering is complete?

Have you used other nutrients to help while tapering or post taper? If yes, which ones?

Did you find that GABA was not helpful? (which product and how much did you use?)

If you have questions please share them here too.

Low lithium questionnaire and how we use lithium orotate with the amino acids

August 19, 2022 By Trudy Scott 44 Comments

This is the low lithium questionnaire that I use with new clients in order for us to figure out if a trial of low dose lithium, in the form of lithium orotate, may be helpful. The hallmark of low lithium is a rollercoaster of emotions. Keep in mind that this is just one of 12 questionnaires that I have my clients complete. Many of the following symptoms can have multiple causes, the labs may relate to other deficiencies and the conditions have other root causes. This questionnaire simply provides additional evidence that lithium orotate may help.

We typically do a lithium orotate trial, starting with 5 mg once a day, and going up to 10 mg twice a day. We do this after we have started trialing the respective amino acids for low serotonin, low GABA, low endorphins, low catecholamines and low blood sugar. A big clue that lithium orotate may be helpful (when many of the symptoms below are checked off) is when the amino acids for low serotonin (tryptophan or 5-HTP), low GABA (GABA or theanine), low endorphins (DPA or DLPA), low catecholamines (tyrosine or DLPA) and low blood sugar (glutamine) are not as effective as expected (based on the amino acids mood/neurotransmitter questionnaire).

Low lithium questionnaire

Symptoms
Mood swings (a rollercoaster of emotions)
Addictions and/or cravings
Depressed
Low self-esteem
Boredom
Easily distracted
Rebellious, disruptive behavior and/or aggressiveness
Irritability
Restless/internal anxiety (similar to low serotonin worry/ruminating anxiety)
Restless/external anxiety (similar to low GABA physical anxiety)
Anxiety ups and downs (fluctuations)
Melancholic pessimism
Suicidal thoughts
Disorganized with planning difficulties
Focus issues/ADHD
Insomnia
Procrastination and/or no initiative
Jack of all trades, master of none
Impulsive and/or lacking tact
Poor insight
Risky behavior
Cognitive issues
Migraines or cluster headaches

Effectiveness of amino acids
The amino acids for low serotonin, low GABA, low endorphins, low catecholamines and low blood sugar are not as effective as expected (based on the amino acids mood/neurotransmitter questionnaire)

Labs
Low white blood cell count
Low red blood cell count
Anemia
Low platelet count

Conditions
Anorexia nervosa
Heart disease (heart arrhythmias, history of heart attack)
Raised blood sugar or diabetes
Kleptomania
Alcoholism
Alzheimer’s disease
Fibromyalgia
Bipolar II
Gout
Hyperthyroidism
Nearsightedness or glaucoma
Herpes infections (current or prone to them)

If you are new to low dose lithium / lithium orotate

As I share in this blog, Upping my tryptophan and lithium orotate have been absolutely profound for me: I’ve been depression free and anxiety free for over a year, I’ve used lithium orotate with many clients and use it when folks have mood swings and anxiety ups and downs. It’s harder for the amino acids to work when there is a moving goal post and lithium orotate evens things out.

You can read Katrin’s wonderful results: “Upping my tryptophan dose and also including and upping the dose of lithium orotate has been absolutely profound for me. I’m off my SSRI/antidepressant (which I was off and on for a number of years). I’ve been depression/anxiety free for over a year. So fantastic.”

The above blog also includes additional information on the differences between low dose lithium / lithium orotate and prescription lithium carbonate. The latter is used at much higher doses and does have side-effects.

One of the many ways lithium works is via the impact on neurotransmitter production. This paper, Potential Mechanisms of Action of Lithium in Bipolar Disorder, states this: “At a neuronal level, lithium reduces excitatory (dopamine and glutamate) but increases inhibitory (GABA) neurotransmission.” It also increases protective proteins such as BDNF (brain-derived neurotrophic factor), helps reduce oxidative stress and is neuroprotective. This paper is referring to lithium carbonate and not lithium orotate but until we have more research on lithium orotate, I feel comfortable extrapolating, given what I’ve seen clinically with lithium orotate.

I’ve also blogged about low dose or microdose lithium here: Microdose lithium formulation is capable of halting signs of advanced Alzheimer’s and improving cognition. In a study published in 2020, “a team of researchers has shown that, when given in a formulation that facilitates passage to the brain, lithium in doses up to 400 times lower than what is currently being prescribed for mood disorders is capable of both halting signs of advanced Alzheimer’s pathology and of recovering lost cognitive abilities.” In this study, they used lithium citrate in similar doses as the lithium orotate i.e 3.2 mg to 6.4 mg NP03 based on 70kg of body weight (which is around 154.3 lbs).

Resources if you are new to using the amino acids as supplements (and where to get lithium orotate)

If you are new to using any of the amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances).

You can find the amino acid products I use and a number of different lithium orotate products in my online Fullscript store.

Do you resonate with any of the above and have you used lithium orotate with success?

Was the rollercoaster of emotions and fluctuating anxiety a hallmark for you before using lithium orotate?

If you’re a practitioner, do you use lithium orotate with your clients or patients?

If you have questions please share them here too.

The importance of addressing pyroluria with chronic Lyme disease (and co-infections), MCAS (Mast Cell Activation Syndrome) and other chronic illnesses

August 5, 2022 By Trudy Scott 27 Comments

Pyroluria is a social anxiety condition that responds well to zinc, vitamin B6, evening primrose oil and a few other key nutrients, typically resulting in resolution of social anxiety symptoms within a few weeks with the correct combination and dosing. However there is much more to pyroluria than meets the eye. Addressing this biochemical imbalance is crucial for recovery from chronic Lyme disease (and co-infections), MCAS (Mast Cell Activation Syndrome) and other chronic illnesses caused by heavy metal toxicity, mold toxicity, multiple chemical sensitivities and Ehlers Danlos syndrome (amongst others).

Dr. Neil Nathan, MD, author of Toxic: Heal Your Body from Mold Toxicity, Lyme Disease, Multiple Chemical Sensitivities, and Chronic Environmental Illness (2018), shares this about pyroluria and chronic illness:

This biochemical imbalance is surprisingly common in chronically ill patients, and missing this diagnosis (by neglecting to test for and treat it) also denies us the opportunity to provide a simple, benign treatment that can help quiet down patients’ already overstimulated nervous systems.

(Here is my Amazon link to his book, which is excellent)

For over 15 years Dr. Dietrich Klinghardt has been saying you won’t see success with Lyme disease without also addressing pyroluria. He has seen a correlation with all his patients with chronic illness and pyroluria.

Let me quote from an article by Scott Forsgren, FDN-P and Dr. Dietrich Klinghardt, MD PhD: Kryptopyrroluria (aka Hemopyrrollactamuria): A Major Piece of the Puzzle in Overcoming Chronic Lyme Disease (a Townsend letter article published in 2017):

Based on testing with a lab in Holland, Klinghardt has found the incidence of KPU [Kryptopyrroluria or pyroluria] in Lyme disease to be 80% or higher; incidence of KPU over 75% in patients with heavy metal toxicity (lead, mercury, aluminum, cadmium, and others) and in children with autism over 80%.

These are very significant percentages of the patient population with chronic illness that may benefit from a treatment program that addresses KPU.

They also state what has long been known when it comes to pyroluria: symptoms are made worse by stress and “chronic infections, such as Lyme disease, may themselves serve as a trigger for the condition (of pyroluria).”

When it comes to MCAS, an updated version of this same article states that:

Klinghardt has worked with biochemists in Germany that are beginning to link KPU with mastocytosis or mast cell activation syndrome (MCAS).

They have observed that KPU treatment repairs the heme molecule, which notably stabilizes the mast cells and lowers the response to these relative rises in histamine.

I use the term pyroluria in this article, throughout my blog and in my book. It was coined by Carl Pfeiffer, MD PhD in the 1970s (after its discovery by Abram Hoffer in 1958). You’ll see these other terms used in various articles and in some of the older research: kryptopyrroluria (KPU), hemopyrrollactamuria (HPU), pyrrole disorder, mauve factor and sometimes malvaria.

As I shared in my interview with Dr. Kelly MCann on the summit, The Many Manifestations of Mast Cell Activation, it would be wonderful to get the terminology standardized and to get some case studies published. This would allow it to gain more acceptance in the mainstream and in functional medicine.

These papers, Discerning the Mauve Factor, Part 1 and 2, highlight some of the mechanisms as to why addressing pyroluria is so important:

“Treatment with nutrients – particularly vitamin B6 and zinc – reduces urinary excretion of HPL and improves diverse neurobehavioral symptoms in subjects with elevated urinary HPL.
Heightened HPL excretion classically associates with emotional stress, which in turn is known to associate with oxidative stress.
HPL correlated inversely with plasma glutathione
HPL is a promising biomarker for oxidative stress. HPL is known to cause non-erythroid heme depression, which lowers zinc, increases nitric oxide, and increases oxidative stress.”

The Forsgren/Klinghardt article above, covers additional mechanisms. With regards to MCAS specifically, the pyroluria supplements – zinc, vitamin B and evening primrose oil – all play a role in reducing histamine, providing immune support and reducing inflammation. And they provide nutritional support for the anxiety and mental health aspects of the condition – directly for pyroluria and indirectly via neurotransmitter support (since they are necessary cofactors for making serotonin and GABA).

Here is some of the research I gathered on some of the ways zinc, vitamin B6 and evening primrose oil (EPO) may help when it comes to MCAS:

This paper, Role of Zinc Signaling in the Regulation of Mast Cell-, Basophil-, and T Cell-Mediated Allergic Responses, states that “zinc signaling dysregulation is a leading health problem in inflammatory disease and allergy…. These findings may lead to future therapeutic applications for suppressing inflammatory or allergic responses.”
In this paper, Effect of pyridoxine on histamine liberation and degranulation of rat mast cells, the authors share that vitamin B6 “significantly inhibited rat mast cell degranulation and histamine release induced by egg albumin allergen.” This paper also discusses the lack of toxicity of vitamin B6 and “the possibility that other mechanisms of action may be involved, such as the improvement in tryptophan metabolism.”
This paper, Alterations of mast cell mediator production and release by gamma-linolenic and docosahexaenoic acid/DHA, was looking at mastocytoma (a type of mastocytosis) using a cell line as a model for canine atopic dermatitis (cells were incubated with the wasp venom peptide.) They found that “GLA decreased histamine release …and DHA diminished prostaglandin production.” Evening primrose oil is a source of GLA and fish oil is a source of DHA.

If you’re new to MCAS, Dr. Jill Carnahan has an excellent overview here: Mast Cell Activation Syndrome: Here’s What You Need to Know When Histamine Goes Haywire and I’ve blogged about PharmaGABA often being an issue and making anxiety worse when you have MCAS or histamine issues.

The ramifications of this biochemical imbalance are far-reaching

Here is the pyroluria questionnaire / symptoms list (from my book, The Antianxiety Food Solution). It has been updated with recently with additional conditions. You can read about pyroluria prevalence and associated conditions here.

Here are some of my pyroluria blog posts you may find useful (click each of the linked articles to read further). As you will see the ramifications of this biochemical imbalance are far-reaching:

Feel free to use the search feature on the blog to find additional information about pyroluria. I have written about it extensively. I have it myself and it’s really common – I see it in about 80% of my community – so I am pretty passionate about the topic.

Resources if you are new to pyroluria

If you are new to pyroluria, there is an entire chapter on the topic in 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 the pyroluria supplements on your own. And be sure to share it with the practitioner/health team you or your loved one is working with. We need the wider practitioner community to be aware of this condition and the importance of addressing it.

I use individual amino acids such as GABA and tryptophan with all my anxious clients and we always layer in the pyroluria protocol. There is also an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, self-medicating with alcohol and more.

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 acids and pyroluria supplements that I use with my individual clients and those in my group programs.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. This is a paid online/virtual program with an opportunity to interact with me and other practitioners who are also using the amino acids and pyroluria protocol with success with their clients/patients.

Have you used the pyroluria protocol as part of your recovery from chronic Lyme disease or MCAS (or another chronic illness)?

Did you learn about this from your practitioner or elsewhere? (please share where)

If you’re a practitioner, is the pyroluria protocol part of your plan for clients and patients? And has it been a game-changer for them?

If you have questions please share them here too.