Archives for December 2022

Irukandji syndrome: severe pain, nausea, breathing difficulties and a feeling of impending doom (impact on serotonin and other neurotransmitters?)

December 30, 2022 By Trudy Scott 14 Comments

Irukandji syndrome is in the news again. In addition to the jellyfish sting causing severe pain, nausea and breathing difficulties, the research states there is a feeling of impending doom after you’re stung. I’m sharing this current news from Australia and a recent study because I’m curious about the mechanisms and short- and long-term impacts on serotonin and other neurotransmitters, likely affecting anxiety, depression, pain and insomnia. And I’d like to help create awareness since there is not 100% consensus on what to do right away after a sting and less awareness in the medical community than I feel comfortable with.

From the ABC article published this week in Australia: “Another child has been flown to Hervey Bay Hospital with a suspected Irukandji sting after swimming in a creek off Wathumba Road on K’gari (Fraser Island) in Queensland, Australia on Wednesday afternoon.

The key points of the article:

“Three young girls and a boy have been flown to hospital with suspected Irukandji stings in the past two days
The jellyfish stings can cause severe pain, nausea and breathing difficulties
A Toxicologist is calling for more research into their movements and physiology”

The yahoo news article expanded on the symptoms: “They have this severe body pain, often low back pain, nausea, vomiting, and this feeling of impending doom that sort of lays over the top of this whole thing.”

I found the latter interesting as impending doom is a classic sign of low serotonin. So I went digging into the research. I was enlightened and surprised by what I found.

Raising awareness on this worldwide increasing threat

This 2022 paper, Raising Awareness on the Clinical and Forensic Aspects of Jellyfish Stings: A Worldwide Increasing Threat is eye-opening and concerning and also mentions the impending doom symptom.

Irukandji syndrome is a severe illness produced by the envenomation i.e. injection of venom, of some species of small jellyfish from the Cubozoa class, known as box jellyfish.

It consists of a clinical picture dominated by systemic symptoms similar to a catecholamine surge, including hypertension, tachycardia, intense pain, and muscle cramping, eventually leading to pulmonary edema, shock and cerebral hemorrhage.

Also listed are symptoms of anxiety, restlessness, headache, localized sweating and impending doom. A feeling of impending doom is a classic symptom of low serotonin.

With regards to Irukandji syndrome it’s becoming a worldwide problem: “The first cases described happened in the northern Australian territories. However, similar disorders have been observed all over the tropical waters, including Thailand, the Caribbean, Florida, and Hawaii.”

The good news is that the authors state “Irukandji syndrome is typically not deadly, especially if supportive care is given early” and “not all encounters with species capable of producing Irukandji syndrome result in this clinical state.” They also share that typically the severe pain only lasts a few hours but do mention one case where “pain recurred up to a year later.” I discuss possible longer term effects below.

As you read the paper, be aware there are many types of jellyfish with many different mechanisms. Cubozoa includes the deadliest jellyfish species and includes Carukia barnesi and Chironex fleckeri. (commonly known as the Australian box jelly). It’s the Carukia barnesi that causes Irukandji syndrome.

The images in the above paper are graphic so be warned.

There is not 100% consensus on what to do right away

What is also really concerning is that there is not 100% consensus on what to do right away. This 2017 paper, Cubozoan Sting-Site Seawater Rinse, Scraping, and Ice Can Increase Venom Load: Upending Current First Aid Recommendations, published by Hawaiian researchers, found the “best outcomes occurred with the use of venom-inhibiting technologies (Sting No More® products)” and they state not to use a sea water rinse. They also found vinegar and heat treatment were less effective with certain types of jellyfish.

And yet the tentative recommendation from the above 2022 paper is to use vinegar, heat, sea water, and careful removal of remaining tentacles with tweezers quickly because only “about 1% of nematocysts (stinging cells) discharge upon initial contact.” They do suggest using Sting No More® before removing tentacles in order to deactivate the nematocysts.

I’m not sharing any of the above as conclusive in all situations but more to illustrate what both papers state: further research is needed in different places of the world, as different jellyfish species seem to react differently to the treatments.

There is also less awareness in the medical community than I feel comfortable with hence my desire to share this so you are more aware if you or a family member is stung by a jellyfish.

Are there possible long-term impacts on anxiety, depression, pain and insomnia? (and the potential role of amino acids)

Just like we have long-term impacts on anxiety, depression, pain and insomnia with Lyme disease and other infections like Bartonella – due to effects on serotonin, GABA and other neurotransmitters – do we need to consider these long term impacts after a jellyfish sting too?

I have to wonder if there are also longer term impacts given the trauma of the situation and the many medications that are needed to save your life: nitroglycerin, opioids, benzodiazepines and others.

If mood, anxiety, pain and sleep issues persist after the acute recovery phase (which can take up to 3 months and more) and there are other signs of low serotonin, GABA, dopamine and endorphins, it’s important to consider the use of targeted amino acids. I recommend tryptophan or 5-HTP for low serotonin symptoms (worry type of anxiety, insomnia and low mood), GABA for low GABA symptoms (physical anxiety and tension), tyrosine for low dopamine symptoms (depressed with low energy and poor focus) and DPA for low endorphin symptoms (pain and weepiness).

It would be wonderful to see research in this area.

Is there a possible role for GABA right after the sting too?

Given there is “hypertension, tachycardia, intense pain, and muscle cramping”, would the amino acid GABA help?

With Irukandji syndrome, “there have been reports of blood pressures as high as 300/180 mmHg” (normal is 120/80 mmHg). In one study, 80mg GABA was found to reduce mild hypertension and it’s possible that a higher dose of GABA may help right after the sting. It may also help to alleviate pain and muscle tension/muscle cramping too.

It would be wonderful to see research on GABA use right after the sting too.

Resources if you are new to using amino acids as supplements

If you are new to using GABA or any of the other 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 and low serotonin).

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.

I do hope these 4 young Australian children are doing well after having been stung.

Have you or a family member been stung by a jellyfish? Where did it happen and what type of jellyfish? What symptoms did you experience? What was the treatment and what was recovery like?

Have you or your family member had any long-term lingering symptoms of anxiety, depression, pain and insomnia? Have the amino acids or other solutions helped?

If you’re a practitioner have you seen long-term lingering symptoms of anxiety, depression, pain and insomnia in your clients/patients who have had a jellyfish sting?

Feel free to post your questions and feedback in the comments below.

GABA is not the same as gabapentin. GABA (gamma-aminobutyric acid) is an amino acid supplement; gabapentin is a prescription medication

December 23, 2022 By Trudy Scott 53 Comments

One common question I hear from folks who are new to my work is this: “is GABA the same as gabapentin?” Quite frankly it has always surprised me to get this question since they are different words – why would you think they are the same? But I’d carefully explain the difference, educate the person and move on. A few months ago I shared a blog post on how the amino acid GABA was effective for an 11 year old with ADHD, irritability, anxiety and tantrums and someone asked this question again: “GABA sold at health store or prescription Gabapentin?”

I decided it was finally time to ask why she thought they may be the same thing. I first explained what GABA is (an amino acid supplement), shared some links to products and said “no, not prescription Gabapentin – I’m curious why you’d think that?”

She replied that “some people refer to GABA the same as Gabapentin” and thanked me for the clarification.

I appreciate her response but it did still concern me that the amino acid GABA is lumped together with prescription gabapentin. My next step was a facebook post sharing the above dialogue and asking my community there for feedback: “Have you heard GABA and gabapentin used interchangeably? Did you think they were the same thing at one stage?”

The response was enlightening, hence this blog post to provide clarification if you’re not sure either or if you know exactly what GABA is but have had confused conversations with your practitioner, family members, friends and/or colleagues. And to also get your feedback on this topic.

GABA is not the same as gabapentin. GABA (gamma-aminobutyric acid) is an amino acid supplement and neurotransmitter; gabapentin is a prescription medication. They are often used interchangeably (as you’ll read below) and should not be!

GABA and gabapentin is used interchangeably by a variety of practitioners

Here are some of the many responses showing how GABA and gabapentin is used interchangeably by a variety of practitioners:

Jennifer shared this: Yes in the vet world, gabapentin is often called gaba. Not surprising since western medicine likes to pretend that supplements don’t exist. I didn’t know GABA existed as a supplement for many years. I always explain what it is when I talk about it, to make sure there’s no confusion.

Val shared this: I was just at the dentist and I shared that I take Gaba to help me sleep. She said “Gabapentin?” I said “no I don’t take a synthetic medication, instead I take Gaba which is an amino acid.” It’s good to share with all who are willing to listen.

Katie shared this: I have never heard them used interchangeably but, whenever I talk about GABA, I say “GABA otc amino acid, not gabapentin the prescription” to be extra clear and educational.

Heather said: I was wondering this earlier in the week. My husband’s [nurse practitioner] suggested gabapentin temporarily for a back injury but she used the term “gaba”. I quickly got clarification. Hopefully she won’t do that again. But I understand it. Her field is all pain management.

Theresa shared this: Nurses who don’t know medicine often do that. I’ve found that [gaba] is listed in my med list when they don’t seem to know the difference.

Laura shared this: I always knew that they were different but I have had psychiatrists use them interchangeably.

Bonnie shared this: I mentioned GABA to my dad’s nurse and she got all upset, thinking I meant Gabapentin. At the time I didn’t know it was two different things. Dad was in the hospital and I suggested gaba to calm him. She said, no, no, no! I didn’t realize we were speaking of two different things.

Lisa shared this: When I told my primary doctor [an MD] that I was taking Gaba instead of prescription drugs she asked “gabapentin?” I said “no, Gaba which is a supplement”. She looked confused.

Lindy shared this: It’s a common assumption. I think some GPs (general practitioners) shorten gapapentin to gaba.

Jane shared this: “Yes – I am very careful to say the “supplement GABA.” I mentioned it to an Anesthesiologist when I had surgery. I normally don’t tell the medical profession my supplements – they have no idea what they are. I do specify the “supplement GABA” to holistic providers – I don’t want any misunderstanding. I was on Gabapentin and Lyrica for a long time. Horrific medications with severe consequences

If you relate to any of this feedback, keep sharing in order to educate, explain the difference and clarify to make sure there is no confusion.

What is GABA?

If you are new to the amino acid GABA, it’s a supplement that is used to raise low GABA (the neurotransmitter) levels and ease the physical-tension and stiff-and-tense-muscles type of anxiety.

The other symptoms we see with low GABA are panic attacks, physical tension in certain settings like public speaking or driving, and the need to self-medicate to calm down, often with alcohol but sometimes with carbs and sugary foods. Insomnia can also be due to low GABA and you’ll experience physical tension (rather than the ruminating thoughts which is the low serotonin type of insomnia – although it’s not uncommon to experience both). GABA also helps with muscle spasms and pain relief when muscles are tight.

You can read this blog, GABA for the physical-tension and stiff-and-tense-muscles type of anxiety for my biggest takeaways for using GABA effectively. I also share a number of GABA products and some feedback from folks who have experienced the benefits. One example is this:

I have used GABA (several brands, just open a capsule and sprinkle a small amount under the tongue) for years now, with calming results within minutes.

With regards to the question about GABA being available in health stores: there are amino acid supplements that are available over the counter at a health store and also via my online health store here (these are products I have vetted and use with clients).

Here is the blog I referred to above: GABA for children: ADHD, focus issues, irritability, anxiety and tantrums. My blog is a wealth of information when it comes to GABA so be sure to use the search feature.

What is gabapentin?

Per the Cleveland Clinic site:

Gabapentin is a prescription medication known as a gamma aminobutyric acid (GABA) analogue. GABA reduces the excitability of nerve cells (neurons) in the brain, which play a role in seizures and the transmission of pain signals. Gabapentin mirrors the effects of GABA calming excited neurons. Gabapentin is in a class of medications called anticonvulsants.

It’s been approved for seizures and nerve pain caused by shingles, however, off-label use is common when it comes to other types of pain, anxiety and depression. This paper, Outpatient Off-Label Gabapentin Use for Psychiatric Indications Among U.S. Adults, 2011-2016 warns of

risks associated with gabapentin combined with central nervous system depressant (CNS-D) drugs, which are commonly prescribed in psychiatric treatment….Over 6 years, 58.4% of off-label gabapentin visits listed one or more concomitant CNS-D medications, most frequently antidepressants (24.3%), opioids (22.9%), and benzodiazepines (17.3%).

The above Cleveland Clinic site lists some brand names – Horizant®, Gralise® and Neurontin® – but it is known by many different names in other countries. You can look it up in your country here.

You’ll also see all the side effects and the fact that dependence and withdrawal is downplayed despite the growing evidence that these are very real issues. More on that below.

There are many issues with gabapentin dependence and withdrawal

This blog post is really about terminology and the interchangeable use of GABA and gabapentin, but if you’re new to gabapentin, it’s important to be aware that there are many issues with dependence and withdrawal (often similar to benzodiazepines):

Withdrawal symptoms after gabapentin discontinuation

On day 3 of hospitalization, she developed restlessness, disorientation, confusion, agitation, and anxiety. She was presumed to be suffering from ethanol withdrawal and was treated with benzodiazepines but had no improvement in symptoms. During days 4 and 5, the patient became increasingly confused, agitated, and anxious, with complaints of headache, light sensitivity, and increasing nervousness. On day 5, gabapentin was reinitiated, and the patient’s confusion and agitation improved that evening. The next morning, the patient was calm, alert, and cooperative.

Akathisia induced by gabapentin withdrawal

To our knowledge, this is the first reported cases of akathisia induced by gabapentin withdrawal. Available case reports suggest that gabapentin withdrawal can occur at doses ranging from 400-8000 mg/day. Patients experienced symptoms similar to those that develop with benzodiazepine withdrawal and were taking gabapentin for as little as 3 weeks to as long as 5 years.

Gabapentin dependence and withdrawal requiring an 18-month taper in a patient with alcohol use disorder: a case report

This case highlights the need for patient-centered slow tapers in patients with severe gabapentin dependence and withdrawal.

The withdrawal took 18 months.

There is one case report of macular edema after gabapentin use and gabapentinoid (pregabalin/Lyrica) more so than gabapentin/Neurontin) prescriptions increased risk of suicidal behavior and unintentional overdose.

This 2017 paper, Gabapentin and pregabalin: do the benefits outweigh the harms? summarizes as follows: “Prescribers should be aware of the very limited clinical evidence for use of gabapentin and pregabalin outside their licensed indications, as well as their capacity to do harm.”

The amino acid GABA has none of these issues.

Why it may be confusing for practitioners

Other than the fact that gabapentin is described as a GABA analogue, I can see why it may be confusing for practitioners who don’t yet know about my work and the amino acid GABA.

The fact that GABA is an amino acid supplement and also a neurotransmitter may also be contributing to some of the confusion.

The other fact that I believe is adding to the confusion is because of how gabapentin is often referred to in the research. Let’s take this 2020 paper as an example: γ-Aminobutyric Acid and Derivatives Reduce the Incidence of Acute Pain after Herpes Zoster – A Systematic Review and Meta-analysis

It has γ-aminobutyric acid and derivatives in the paper title and as part of the aim, is mentioned in the results and elsewhere too:

The aim of the present study was to investigate the effectiveness of GABA and its derivatives in reducing acute pain incidence in patients having HZ.
The results showed that the treatment with GABA and its derivatives significantly reduced the number of patients with acute zoster pain.
There is no guideline for using and dosing GABA and its derivatives to prevent acute HZ pain.

And elsewhere they refer to GABA-like compounds:

The optimal dosage of GABA-like compounds is still to be determined.
Nevertheless, the presently available data indicate that the application of GABA-like compounds in this respect is very promising.

The entire review is about gabapentin/neurontin and is not about the amino acid GABA at all, even though the search terms used for this paper included: gamma-aminobutyric acid and gaba.

This is just one example of many such papers. I know what the amino acid GABA is and I was initially confused when reading the title and abstract, and even when reading the full paper (initially hopeful the paper would also be discussing the amino acid GABA).

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

I appreciate these women for sharing their interactions with practitioners so we can all be enlightened.

Have you heard GABA and gabapentin used interchangeably? Did you think they were the same thing at one stage?

How do you refer to GABA and gabapentin in order to avoid confusion?

If you’ve been prescribed gabapentin what was/is it prescribed for? And did you/do you also have a prescription for an antidepressant, opioid or benzodiazepine?

Have you had/do you have any issues using gabapentin?

Have you had success using the amino acid GABA? If yes, what for?

Feel free to post your questions and feedback in the comments below.

GABA supplementation may offer a new approach for the prevention and treatment of asthma (and it helps anxiety, ADHD and insomnia)

December 16, 2022 By Trudy Scott 12 Comments

If you’re already taking the amino acid GABA for physical anxiety, have you noticed if it’s also helping to ease your asthma symptoms too? This may sound surprising but research shows GABA may reduce inflammation and spasms and help with asthma symptoms via these mechanisms. What’s encouraging is the fact that GABA supplementation also helps with anxiety, obesity, ADHD and insomnia which commonly occur with asthma and can be associated with inflammation too. It’s so important to be addressing the root causes of asthma because of the many neuropsychiatric side-effects of asthma medications. This blog addresses all of these topics.

We’ll start with the research first. In this study, Effect of gamma-aminobutyric acid treatment on plasma substance P and calcitonin gene-related peptide levels in children with asthma, of 75 children with asthma, 36 children were in the GABA treatment group and received oral GABA (25-30 mg/kg per day) in addition to standard asthma medications.

The authors propose that airway inflammation may be a factor in asthma and GABA helps because it reduces SP (substance P) and CGRP (calcitonin gene-related peptide), easing neurogenic inflammation and tracheal spasms.

The conclusion of the study is that oral GABA:

can significantly decrease plasma levels of SP and CGRP in children suffering from acute asthma.

It may offer a new approach for the prevention and treatment of asthma.

(this is my best translation from the Chinese paper).

Dosing of GABA for asthma

The children in the study group received oral GABA of 25-30 mg/kg per day. For a 100 lb /45 kg child this would equate to 1125 mg -1350 mg of GABA per day.

As I always share, I don’t recommend using GABA based on the weight of the person and I consider this a high dose. For adults, 125 mg GABA is a good starting dose with 125 mg often used 2-4 times a day. For a child, ¼ to ⅓ this dose is typically good to start with. All that said, many adults and children with asthma and anxiety need higher doses than what they initially start with.

It’s also worth noting that the oral dose of GABA was swallowed so it’s possible (and very likely) that more was needed than if it was used sublingually or with the capsule opened or a powder or a liposomal form.

GABA is seldom recommended for asthma – more recent research supports this approach

This is not new research – the paper was published in 2013 – but I seldom see it discussed or hear about practitioners recommending GABA for asthma.

A more recent paper, Neuroimmune Pathophysiology in Asthma (published in 2021) supports this and discusses the role of neurotransmitters (including GABA and serotonin) and neuropeptides (including SP, CGRP and others) in asthma. The authors suggest “that regulating the effects of neurotransmitters and neuropeptides represents a potential novel approach for the treatment of asthma.”

Why we need to consider GABA – the neuropsychiatric side effects of asthma medications

Exploring the use of GABA and these approaches is especially important given the neuropsychiatric side effects of asthma medications. In this study (published in March this year), Neuropsychiatric adverse drug reactions induced by montelukast impair the quality of life in children with asthma

Neuropsychiatric ADRs (adverse drug reactions) were reported in 78 (62.4%) of 125 patients, who recovered when the drug was discontinued.

These were children of 3-18 years taking montelukast for the first time. The good news is that they recovered when the drug was stopped.

The bad news is there is no information on how many kids who have been prescribed this class of medication are subsequently prescribed psychiatric medications.

This concern needs to be considered for all asthma medications: there are similar adverse effects with antihistamine and inhaled corticosteroid medications.

GABA helps with other conditions where spasms are common

The study results are very encouraging and support what I see clinically with asthma and other conditions where spasms are common. These include

GABA helps with all of the above and the non-allergic comorbidities seen with asthma.

Asthma in children and non-allergic comorbidities (obesity, depression and anxiety, ADHD and insomnia)

As stated in this paper, Paediatric asthma and non-allergic comorbidities: A review of current risk and proposed mechanisms “It is increasingly recognized that children with asthma are at a higher risk of other non-allergic concurrent diseases than the non-asthma population.” These include obesity, depression and anxiety, neurodevelopmental disorders (such as ADHD), sleep disorders and autoimmune diseases.

This paper looks at mechanisms and inflammation is a common theme except when it comes to anxiety and depression. Given that this paper was published this year and all that we now know about nutritional psychiatry and neuroinflammation and anxiety, it’s clearly lacking in this aspect.

Clinically, we see how GABA can help with obesity (and cravings or stress-eating), depression and anxiety, ADHD and insomnia, as illustrated by these case studies:

I see similar comorbidities (the occurrence of more than one disorder at the same time) in adults and GABA can be used safely with adults and children.

Asthma from a functional medicine approach

There is clearly more to asthma than only GABA. This this article on natural remedies for asthma covers diet (eat real good quality food and avoid junk food), nutrients like vitamin D, zinc and others, and allergens – and all this needs to be investigated and addressed with a functional medicine approach.

Dr. Axe does mention stress and anxiety being a trigger: “It’s well-known that stress increases the severity and frequency of asthmatic attacks because it hinders immune function and raises inflammation.” He mentions stress-reduction techniques and breathing. I say let’s add GABA to the mix too.

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

Has GABA helped ease your physical anxiety and asthma symptoms too?

What about obesity/cravings, ADHD and insomnia as well?

Have you or one of your children been adversely impacted by asthma medications? If yes please share which medications and what symptoms were experienced.

What functional medicine and nutritional approaches have helped your asthma symptoms?

Feel free to post your questions and feedback in the comments below.

5-HTP with Paxil, when nursing, for men, with insomnia in Parkinson’s and when it gives you nightmares: questions and answers

December 9, 2022 By Trudy Scott 8 Comments

5-HTP is an amino acid, made from the seeds of an African plant, Griffonia simplicifolia, and used as a supplement to ease low serotonin symptoms of worry-type anxiety, often with ruminations, obsessing and panic attacks. When you have insomnia caused by low serotonin you may lie awake worrying. This type of anxiety is different from the low GABA physical/tension type anxiety. Other low serotonin symptoms include low mood/depression, late afternoon and evening carbohydrate cravings, pain, digestive/IBS symptoms, PMS, irritability, rage and anger, TMJ, low confidence, imposter syndrome and perfectionism.

I’ve blogged about 5-HTP extensively and I receive many great questions about this supplement. Today I’m going to share some of these questions and my answers so you can get the benefits too: using it with Paxil, insomnia when you have Parkinson’s disease, if 5-HTP works for men, timing of 5-HTP with nightmares and if 5-HTP can be used in pregnancy and when nursing.

Haley shared how 5-HTP helps with insomnia and asks about taking it with Paxil:

I was taking 5-HTP and it definitely helped me sleep at night. I recently started Paxil for my panic attacks after a recent trauma and I’m no longer sure if I can take Paxil with 5-HTP or not?

I’m so glad to hear 5-HTP helped with sleep. I’m sorry to hear about your recent trauma but keep in mind the other benefits of 5-HTP – helping with panic attacks is just one. When I’m working with someone who has experienced something like this and is already seeing benefits with 5-HTP, we increase their 5-HTP to help with the panic attacks too.

If they have already started Paxil and would prefer to stop using it I have them read this tapering blog and work/discuss with their prescribing doctor. There is the risk of serotonin syndrome with SSRIs (such as Paxil) and 5-HTP (and tryptophan).

There are many nutritional solutions for trauma and psychological stress (a natural disaster or anything else) and we’d address all this too.

Lynn has Parkinson’s disease and sleep problems:

I have Parkinson’s and sleep is starting to be an issue. I usually fall asleep but after about 4 hours I’m wide awake. I’m afraid this sleeplessness will negatively affect my brain if I can’t remedy this. I take carbidopa/levodopa. I’ve seen a sleep neurologist and she wants to prescribe drugs which again I’m afraid will have a negative effect on my brain. Your suggestions around 5-HTP would be very much appreciated.

We always start with the low serotonin symptoms and do a trial of either 5-HTP or tryptophan if it looks like low serotonin is the root cause of the sleep issues (there are many other root causes of insomnia).

If you score high on many of the low serotonin symptoms I suggest sharing this 5-HTP/Parkinson’s disease blog post and research with your sleep neurologist and Parkinson’s doctor: “Research shows that the amino acid 5-HTP (5-hydroxytryptophan), the intermediate metabolite of tryptophan in the production of serotonin, offers benefits for Parkinson’s disease patients. It has been reported to ease depression and to reduce levodopa-induced motor complications. This was reported in two separate studies by the same research team at the University of Cagliari, Cagliari, Italy. They were small studies and considered preliminary.”

Meleah asks about using 5-HTP with men:

Hi Trudy, did you recommend the same protocol for men? Most of the examples are about women and I have a male friend who needs help

Generally speaking the amino acids work the same for men but I have found that the impact they have on the sex hormone estrogen when using 5-HTP or tryptophan (and progesterone when using GABA) means they tend to work exceptionally well for women.

I also have much more experience working with women so I have more to share on these outcomes. With the few men I have worked with I find they tend to under-report when looking at their low serotonin symptoms so this needs to be taken into account when doing the trial of 5-HTP or tryptophan.

Scott shared how he uses 5-HTP for insomnia and his solution for preventing nightmares when using it:

In regards to nightmares with 5-HTP, I definitely seem to experience disturbing dreams when I take it within 4 hours of bedtime. Therefore, I normally don’t take any after 7pm but do take it periodically throughout the day.

I also suggested it to a friend who tried and likes it very much, however, he experienced excessive dreaming which interferes with him sleeping soundly, so I suggested the same protocol to him.

When I was in college, I am now a senior, I tried taking regular tryptophan and soon started having nightmares and hallucinations as I began seeing faces on the wall when I was trying to fall asleep.

I only take 5-HTP now, in extended release 200mg tablets from the Natrol company. Thank you, Trudy, for bringing this subject up.

I thanked him for sharing this interesting nuance of nightmares with 5-HTP and using it in the day instead. (which I blogged about here i.e. some folks do get nightmares when using 5-HTP)

I’m glad he figured this out and it helps since tryptophan does cause him nightmares. We are all so different and have to find what works best for our unique needs.

Carly asks about using 5-HTP when nursing:

Can someone take 5-HTP while nursing?

5-HTP has not been studied during pregnancy or nursing but a free form amino acid blend that does contain tryptophan is often very helpful. You have to really look for these because many companies choose to leave out tryptophan. I have a few listed on the supplements blog.

Other approaches to improve mood, reduce anxiety and help with sleep while nursing include exercise, yoga, diet and bright light therapy/full spectrum light. Dr. Aviva Romm writes about herbs for anxiety and specifies which are safe while nursing.

If you are new to other anxiety nutrition solutions like gluten/sugar/caffeine removal, blood sugar control, gut health, and pyroluria my book “The Antianxiety Food Solution” is a great place to start for the foundations. Much of this helps with low mood, cravings and insomnia too. More here.

5-HTP is often successfully used in conjunction with other amino acids

Here are some useful blogs related to low serotonin and 5-HTP. As you can see, it’s often successfully used in conjunction with other amino acid supplementation:

You can see all the low serotonin symptoms here.
Fibromyalgia: tryptophan or 5-HTP for anxiety, depression, pain and insomnia
GABA is a life saver for anxiety, theanine helps at night (insomnia) and 5-HTP makes a significant difference in lessening daily pain
Drastic reduction in intrusive thoughts, anxiety and fears (and better sleep) with GABA, tryptophan, 5-HTP and the pyroluria protocol
If low GABA type anxiety and insomnia is also an issue you may find this helpful too – GABA for easing physical anxiety and tension: some questions and answers.
An amino acid supplement with DLPA, glutamine and 5-HTP eases alcohol withdrawal symptoms at an inpatient detoxification program
You can see the 5-HTP and tryptophan products (and GABA) I use with my clients here on the supplements blog.

As always, it’s not only the low serotonin we need to address. 5-HTP offers quick relief but we must always do a full functional workup looking at diet, nutritional deficiencies, digestion, all hormones, toxins and infections (and so on) so we can address all possible root causes – and why serotonin is low in the first place.

I also want to add that I typically start with tryptophan for low serotonin support simply because I have such good results with it and because 5-HTP can raise cortisol in some folks. If we already have salivary cortisol results and none of the four collections are high then 5-HTP is an option to consider.

Resources if you are new to using 5-HTP and other amino acids as supplements

If you are new to using 5-HTP or any of the other 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 and low serotonin).

Thanks to these folks for asking good questions and for allowing me to share here.

What questions do you have about 5-HTP?

Which low serotonin symptoms can you relate to and has 5-HTP or tryptophan helped? Or have you found success with a combination?

Feel free to post your questions and feedback in the comments below.

GABA Oolong tea in children with autism: improvements in sensorimotor skills, autism profiles, anxiety and sleep (new research)

December 2, 2022 By Trudy Scott 14 Comments

A small feasibility study, A double-blind, placebo-controlled, randomised-designed GABA tea study in children diagnosed with autism spectrum conditions, explored the effect of drinking GABA Oolong tea on sensorimotor skills, autism profiles, anxieties and sleep of children with autism.

It was a very small study with nine children (5 male and 4 female) but the results were very promising… “significant improvement in manual dexterity and some large individual improvements in balance, sensory responsivity, DSM-5 criteria and cortisol levels with GABA tea.”

In addition to reducing anxiety (in all but one participant – more on that below), the paper lists the following additional information related to sensory issues, cortisol levels and sleep:

Results also demonstrated that sensory responsivity improved in two-thirds of the participants and autism symptomology decreased in over half, with four of these individuals being positively re-classified on the DSM-5 scale
Differences between evening and morning cortisol levels, deemed the ‘carryover’ effect and cortisol awakening levels were also decreased in over two thirds of the participants, which we attribute to a reduction in stress response which may have helped to reduce sensorimotor responsivity in individuals with autism.
Contrary to our hypotheses, GABA Oolong tea did not appear to impact sleep, with no discernible differences noted in a range of sleep parameters compared with the placebo, despite parents’ subjective reports that their children appeared to sleep more deeply.

They conclude as follows … “These results suggest that sensorimotor abilities, anxiety levels and DSM-5 symptomology of children with autism can benefit from the administration of GABA in the form of Oolong tea.”

What is GABA Oolong tea?

When I shared this study and results on Facebook, I had a few people ask if they could simply add the amino acid GABA to their Oolong tea: “Is it just brewed tea with GABA powder added? Or does someone make a specific tea? I can totally add some GABA to my daily tea.”

It’s not regular oolong tea with GABA added, instead it’s specially fermented to increase GABA levels naturally. Amber GABA Oolong tea by Meileaf is the actual tea used in the study and they share this on the product page.

The farmers achieve this by alternating the leaves between air and a nitrogen rich environment (with no air) during the oxidation phase. This is done over a matter of hours and naturally increases the GABA levels in the tea leaves.

They also share this: “In order to be called GABA tea, the leaves must contain at least 150 mg of GABA per 100g (normal oolong has about 6 mg so that is 25 times higher).”

GABA Oolong tea does also contain theanine, caffeine and epigallocatechin gallate. There is a large part of the study dedicated to theanine so feel free to read that at your leisure.

How much GABA was ingested by study participants?

It was a surprisingly low dose of GABA! They were given 4 cups a day of the GABA Oolong tea and this provided a total of 39.2mg GABA for the day. The authors share this about the amount of daily GABA the study participants received:

With the GABA Oolong tea the dose would be approximately 280 mg per 100 g tea. Based on using 3.5 g per tea portion this equates to 9.8 mg of GABA; multiplied by 4 throughout the day, being 39.2 mg of GABA.

I’ve reached out to confirm which tea was used in the study since Meileaf mentions that this tea contains 205 mg of GABA per 100 g whereas the study states there was 280 mg GABA per 100 g tea. I see consistency with assessing GABA levels accurately being a possible issue (more on that below).

One of the first questions I had was how could such a small amount – 39.2 mg GABA for the day – be so effective? I typically have clients start with 125 mg GABA and they may end up using this dose 3 or 4 x day (so 375 to 500 mg GABA total for the day.)

That said, we are all unique and as I’ve shared, there can be an extremely large variation in dosing. In this blog I share how Syd gets sleep and body anxiety benefits with just 1.5 mg to 3 mg GABA and yet Christina’s agoraphobic client was able to leave the house with 3000 mg GABA.

My other questions: the placebo, caffeine, a histamine reaction, low cortisol and B1 depletion

With new research there are always many factors to consider and I have a number of other questions I’d love to see addressed:

Why did the placebo tea also contain GABA? It had 22.2 mg per day of GABA – about half that found in the GABA Oolong tea.
GABA Oolong tea does contain small amounts of caffeine and how would this affect susceptible individuals? One child was more anxious – was it due to caffeine or was it too much GABA for his needs or a histamine reaction due to the fermentation process (or something else)?
Do we need to be concerned about long term use and depletion of vitamin B1/thiamine which happens with regular tea.
And what about the effects if someone already has low cortisol levels?
Will there be standard levels and accurate measures of GABA in the various GABA Oolong teas that we can rely on? This applies to consumers and practitioners wanting to try this approach and for ongoing research.
How much of the effect was also due to addressing dehydration and helping with dietary oxalate issues which are known to be common in autism?

Hopefully new ongoing research with more participants will shed light on some of these questions.

I’d also love to see head to head research comparing GABA Oolong tea with supplementation of the amino acid GABA, and a study where both are used for possible synergistic effects.

I do appreciate that the authors attempt to address the GABA blood brain barrier (BBB) debate and how GABA could work, focusing on a permeable blood brain barrier in epilepsy and increased epilepsy in autism. This angle is new to me. I’ve addressed the leaky BBB at length here in my interview with Dr. Kharrazian (it’s a theory) and one of my interviews on a prior Anxiety Summit (there are many possible mechanisms and the peripheral effects).

If you’re new to symptoms of low GABA (and cases highlighting the calming effects of the amino acid GABA used as as a supplement)

GABA (gamma aminobutyric acid) is a calming neurotransmitter and the calming amino acid GABA used as a supplement can raise GABA levels. With low GABA levels you’ll feel a physical-tension and stiff-and-tense-muscles type of anxiety.

Here are are some case studies where you can read about the calming effects (and other benefits) of the amino acid GABA used as as a supplement:

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

Have you used GABA Oolong tea with clients/patients or personally? How much and what benefits have you seen? Which product have you used?

If you’ve also used the amino acid GABA sublingually and with success, I’d love to hear how much (and which product) and how it compares with GABA Oolong tea for anxiety, insomnia, sensorimotor skills and/or autism symptoms (as applicable to you, your child or other family member and/or your client/patient)?

If you have questions please share them here too.