Archives for April 2023

Multiple sclerosis: low endorphin research and the amino acid DPA (d-phenylalanine) for pain, depression, comfort and trauma support

April 28, 2023 By Trudy Scott 8 Comments

The research on the role of low endorphins in multiple sclerosis (MS) is exciting because it creates more awareness about a powerful way to offer pain and mood support if you have been diagnosed with this condition. Typically, I ignore the diagnosis when assessing for low levels of neurotransmitters (via a symptoms questionnaire) and have clients do a trial of the amino acid DPA (d-phenylalanine) if they have physical pain symptoms, experience emotional pain symptoms with excessive weepiness/crying and seek comfort via treats/rewarding foods or the numbing effects of alcohol. However, we now know low endorphins play a role in MS (via the endogenous opioid system). By addressing low levels with DPA, you can find some relief of the above pain/depression symptoms and a need for comfort and numbing. DPA may also offer some trauma support if past trauma is a contributing factor (more on all of this below).

Low endorphins play a role in multiple sclerosis: the research

This 2021 paper, Multiple Sclerosis and the Endogenous Opioid System describes MS and the fact that current therapies have limited efficacy: “Multiple sclerosis (MS) is an autoimmune disease characterized by chronic inflammation, neuronal degeneration and demyelinating lesions within the central nervous system. The mechanisms that underlie the pathogenesis and progression of MS are not fully known and current therapies have limited efficacy.”

What is exciting is the identification of the role of the endogenous opioid system and specific opioid peptides in MS:

Preclinical investigations using the murine experimental autoimmune encephalomyelitis (EAE) model of MS, as well as clinical observations in patients with MS, provide converging lines of evidence implicating the endogenous opioid system in the pathogenesis of this disease.

In recent years, it has become increasingly clear that endogenous opioid peptides, binding μ- (MOR), κ- (KOR) and δ-opioid receptors (DOR), function as immunomodulatory molecules within both the immune and nervous systems.

The endogenous opioid system is also well known to play a role in the development of chronic pain and negative affect [i.e. depression], both of which are common comorbidities in MS. As such, dysregulation of the opioid system may be a mechanism that contributes to the pathogenesis of MS and associated symptoms.

Endogenous means internal i.e natural compounds produced by the body and involved in pain relief and mood improvement. This article, Opioid Peptides, describes peptides as compounds that “produce the same effects as the chemicals known as classic alkaloid opiates, which include morphine and heroin.”

It also mentions three major categories of opioid receptors – mu, delta, and kappa – referred to as MOR, DOR and KOR above.

D-phenylalanine for human “endorphin deficiency diseases”

Unfortunately neither of these papers mentions the amino acid DPA (d-phenylalanine) and the fact that it supports endorphin production (by inhibiting the breakdown of endorphins), reducing pain and improving mood – quickly (as in 5-10 minutes).

The use of DPA is not new information as you can read in this paper from 1982 – D-phenylalanine and other enkephalinase inhibitors as pharmacological agents: implications for some important therapeutic application

A number of compounds have been shown to inhibit the degradation of enkephalins. As expected, these compounds produce naloxone reversible analgesia and potentiate the analgesia produced by enkephalins and by acupuncture.

One of these, D-phenylalanine, is also anti-inflammatory.

D-phenylalanine has proven to be beneficial in many human patients with chronic, intractable pain. It is proposed the enkephalinase inhibitors may be effective in a number of human “endorphin deficiency diseases” such as depression, schizophrenia, convulsive disorders and arthritis.

Such compounds may alleviate other conditions associated with decreased endorphin levels such as opiate withdrawal symptoms.

Prevalence of anxiety/depression and alcohol abuse in MS

As I shared in the recent post addressing low GABA symptoms (anxiety, muscle stiffness, swallowing/voice issues and pain) in multiple sclerosis, anxiety and depression is common in this condition. Alcohol abuse is also high. I shared this paper, The incidence and prevalence of psychiatric disorders in multiple sclerosis: A systematic Review, with the following results:

Among population-based studies, the prevalence of anxiety was 21.9% (and up to 35.0% in some papers), 23.7% for depression …and 14.8% for alcohol abuse.

The above Opioid Peptides paper highlights that the endogenous opioid system may be related to excessive alcohol-drinking behavior. In the work I do with amino acids, I see alcohol used as a way to numb out.

All this supports the fact that the amino acid DPA may help ease symptoms of depression and weepiness seen in MS, and self-medicating with alcohol.

The goal is to use these amino acids instead of needing to use benzodiazepines (covered in the above GABA blog), antidepressants and pain medications.

DPA may help trauma in MS, and the freeze response

This paper, Childhood Trauma in Multiple Sclerosis: A Case-Control Study, suggests an association between childhood trauma and early-life stress and MS:

Although childhood trauma was not associated with the degree of current MS-related disability, patients with MS with histories of physical and/or sexual abuse had significantly higher relapse rates than patients without early-life stress.

DPA may also offer some trauma support if past trauma is a contributing factor. I learned about trauma and the low energy freeze state (a survival mechanism) from Dr. Aimie Apigian, MD, MS, MPH. There is the feeling of numbness and being disconnected when in the freeze state and this eventually becomes the default pattern that the nervous system has been wired into.

Individuals with low endorphins are often in the freeze state and are more emotionally sensitive to everything and because of this they experience much more stress. They also experience a feeling of numbness and feel disconnected. The encouraging news is that the amino acid DPA helps ease the low endorphin symptoms while they are addressing their trauma in other ways, like with somatic work and addressing other biological underpinnings of trauma.

DPA is comforting, helps you feel safe and is often described as feeling like someone just hugged you.

Endorphins and the amino acid DPA (d-phenylalanine) and DLPA (dl-phenylalanine)

If you’re new to endorphins and the amino acid DPA and DLPA here are some blog posts:

Low GABA and low serotonin are common in multiple sclerosis too

Low endorphins are just the tip of the iceberg when it comes to the underlying neurotransmitter imbalances in MS. Low GABA and low serotonin are common too.

As mentioned, I recently blogged about the GABA research and applications of GABA when it comes to multiple sclerosis. Here is that link.

When that blog was published I had a number of questions (see the comments in the above link) from folks asking if GABA could help with similar symptoms in Parkinson’s: swallowing and voice problems, pain and hand spasms. I said yes – if GABA is low, the amino acid GABA will help. As important as your diagnosis is, it’s always the questionnaire/symptoms that help you figure out if it’s worth trialing GABA, DPA or one of the other amino acids.

Both GABA and DPA can help pain symptoms via different mechanisms, so it’s a matter of doing a trial of each amino acid, one at a time and monitoring your response.

Tryptophan and/or 5-HTP may help ease some of the low serotonin worry-type of anxiety, fear, panic attacks, obsessing, low mood and MS-specific pain issues and insomnia.

If you do have more than one imbalance (which is not unusual), you need to figure out which imbalance you have and address that with the relevant amino acids, one at a time. I have clients pick the area that is more problematic for them and start there.

I gathered some of this research while preparing for an interview with the wonderful Dr. Terry Wahls, MD and author of “The Wahls Protocol.” We were both pleasantly surprised to see these endorphin/MS and other neurotransmitter connections.

I really look forward to seeing future research on the use of the amino acids DPA, GABA and tryptophan in MS. And I’d love to be involved in some studies if you are associated with a research facility or do research.

Resources if you are new to using amino acids as supplements

If you are new to using 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, low serotonin and low endorphins).

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, anxiety and mood issues.

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 too). 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.

Do you have multiple sclerosis and has the amino acid DPA helped with your low endorphin symptoms: pain, depression, alcohol addiction, comfort and trauma support?

How much has helped and which product do you use?

Do you find opening a capsule of DPA helps more than swallowing the DPA capsule?

Were you surprised that DPA would help so much?

What else has helped your multiple sclerosis symptoms? And have you also addressed low GABA and serotonin with amino acids GABA and tryptophan?

If you have questions and other feedback please share it here too.

Are adrenal issues causing your anxiety? Highlights from the book: Adrenal Transformation Protocol by Izabella Wentz PharmD

April 21, 2023 By Trudy Scott 8 Comments

This is a guest post from my friend and colleague, Dr. Izabella Wentz, who just came out with her latest book, Adrenal Transformation Protocol (my Amazon link). The book is focused on healing your adrenals, and in it she shares specific strategies to support anxiety. Izabella shares a few of the many strategies with you here in this guest post.

You’ll notice that we share many common approaches:

Addressing low blood sugar (much more on that below)
Caffeine intake: Izabella recommends reducing caffeine but I have found many folks in my community need to quit altogether. I have noticed that those with panic disorders experience increases in symptoms such as nervousness, fear, nausea, heart palpitations, and tremors after consuming caffeine and said the effects were similar to how they felt during a panic attack.
Gluten elimination: Interestingly, I have found in my clinical experience and research that there is a connection between gluten and anxiety, social phobia, depression, and even schizophrenia.
Using herbal adaptogens, addressing nutrient deficiencies, and even pyroluria which can deplete key nutrients needed for adrenal health (especially when under high amounts of stress).

All of her approaches focus on adrenal health specifically and she has now taken over 3000 people on an adrenal healing journey. And 86% of them reported that their anxiety improved after going through her protocol.

By Dr. Izabella Wentz. PharmD

Stress is at the root cause of many chronic health issues, and very well may be at the root of your anxiety, too. Chronic stress can put a burden on our adrenal glands, resulting in an excess of stress hormones like cortisol. The body’s repeated exposure to cortisol can result in increased blood sugar levels, increased heart rate, and increased blood pressure, all of which can lead to feelings of anxiety.

The adrenals are two small glands, located on top of each kidney, that release hormones such as cortisol and adrenaline. Adrenal dysfunction generally occurs when your hypothalamic-pituitary-adrenal (HPA) axis is unable to effectively manage your stress response. The HPA axis describes the interactive feedback loop that takes place among these three endocrine, or hormone-producing, glands. If the communication among these three breaks down, your adrenals and their ability to produce important essential hormones can be jeopardized.

Overactive adrenals can leave you feeling like you’re constantly in “fight or flight” mode. First, your body releases high levels of stress chemicals like adrenaline and cortisol. To ensure you’re ready to defend yourself or run, these chemicals spike your blood sugar, as well as increase heart rate, blood pressure, and insulin levels – making you feel anxious, stressed and wide awake at night.

Chronic stress is one of the most common causes of adrenal dysfunction. Our bodies are well-equipped to respond to acute stressors (like being chased by a bear or getting out of the way of an oncoming car), where we experience activation of the fight-or-flight response, followed by a return to the rest-and-digest state.

However, many of us today face a never-ending presence of stressful, yet non-life-threatening, situations that can lead to the constant activation of the stress response.

With enough chronic stress, the HPA axis becomes overwhelmed and desensitized to the usual feedback loop, and stops sending messages to the adrenals to produce more hormones or less hormones, no matter what’s happening.^[1]

Other common causes of adrenal dysfunction include sleep deprivation, blood sugar dysregulation, and chronic inflammation (which are all forms of stress on the body).

Symptoms of poor adrenal function may include the following:

Feeling overwhelmed
Feeling anxious
Feeling tired despite adequate sleep
Trouble falling asleep or trouble staying asleep
Difficulty getting up in the morning
Dependency on caffeine
Cravings for salty foods (a.k.a. the “I just ate a whole bag of chips” syndrome)
Cravings for sweet foods
Increased effort required for everyday activities
Intolerance to exercise
Low blood pressure
Feeling faint/dizzy when getting up quickly
Easily startled
Mental fog or trouble concentrating
Alternating diarrhea/constipation
Low blood sugar (often presenting as feeling angry when hungry or, as I like to call it, “hangry”)
Decreased sex drive
Decreased ability to handle stress
Longer healing time
Mild depression
Less enjoyment in life
Feeling worse after skipping meals
Increased premenstrual syndrome (PMS)
Reduced ability to make decisions
Reduced productivity
Poor memory

If you have three or more of these symptoms, and if these symptoms developed after experiencing a period of acute or chronic stress, sleep deprivation, an infection, or toxic exposure, chances are that you have adrenal dysfunction.

The anxiety adrenal connection

Anxiety is a hallmark symptom of adrenal dysfunction. When the adrenals are compromised, your resilience to stress starts to go down, and you might start to feel more anxious.

Of course, anxiety and adrenal dysfunction run on a two-way street. Chronic stress and anxiety can tax the adrenals, and weakened adrenals can contribute to feelings of anxiety.^[2]

There’s another connection here that I’d like to highlight, and that is the thyroid. The thyroid is impacted by adrenal function, and anxiety can also be connected to thyroid conditions. In fact, I’ve noticed that up to 50 percent of my clients with anxiety have Hashimoto’s, an autoimmune thyroid condition.

A 2004 study found an association between the presence of a mood or anxiety disorder, and the presence of anti-TPO antibodies (indicating Hashimoto’s).^[3] It also noted that a slight reduction in thyroid hormone secretion (such as that found in subclinical hypothyroidism) may affect mood as well. Therefore, it’s also possible that the anxiety you are feeling is related to your thyroid.

Anxiety solutions: Use the ABC’s

One of the first places to start is with the ABCs of adrenal health – adaptogens, B vitamins, and vitamin C.

Adaptogens both tone down overactive systems and boost underactive systems in the body, and are thought to help normalize the HPA axis. Examples of adaptogenic herbs that may increase the body’s ability to resist stress include: ashwagandha, astragalus, reishi mushroom, dang shen, eleuthero, ginseng, jiaogulan, licorice, maca, schisandra, spikenard, and suma.

Ashwagandha in particular is helpful for stress and anxiety, and it can also support thyroid health. Research supports that ashwagandha may offer antidepressant, antioxidant, anti-inflammatory and neuroprotective benefits.^[4] It also may reduce anxiety, improve sleep, and even help address sexual dysfunction in women.^[5]

Rhodiola is another favorite for stress support, mood support, and improved sleep. Sometimes referred to as golden root, rhodiola focuses on our nervous system health. Izabella has found it to be helpful for those with depressed cortisol levels (which can happen in later stages of adrenal dysfunction).

One of the main chemicals in rhodiola is salidroside, found to have neuroprotective effects that reduce the impact of stress on the immune system and the neuro-endocrine system.^[6] Studies have found an anti-fatigue effect along with cognitive function improvements, such as memory improvements (during stressful conditions), and it’s also been shown to diminish depressive symptoms.^[7]

B vitamins and vitamin C tend to be depleted during times of stress and high cortisol production. In particular, deficiencies in pantothenic acid and biotin (vitamins in the “B” family), have been linked to decreased adrenal function in animals and humans.^[8]

Vitamin C is an important antioxidant that helps support the adrenals, mitochondria, collagen production, and immune function.^[9] It’s also needed for the production of cortisol.

Supplementing with the ABCs is a really good place to start if you’re experiencing anxiety or adrenal dysfunction.

Balancing blood sugar

One of the most important strategies to reduce your anxiety involves addressing blood sugar issues. Blood sugar swings can put us on an emotional rollercoaster.

After consuming carbohydrate-rich foods, some people find their blood sugar goes up too high, too quickly.

This leads to a rapid, sometimes excessive release of insulin (a hormone that regulates blood sugar levels). These insulin surges can cause low blood sugar, which can cause unpleasant symptoms such as anxiety, nervousness, lightheadedness, fatigue, excessive hunger, and “hanger”.^[10]

You can balance your blood sugar by reducing your intake of carbohydrates, and increasing your protein and fat intake. A low-carb or ketogenic diet (a low-carb diet where the body breaks down fats for fuel instead of relying on carbohydrates) could be beneficial for some.

Starting the day off by having a breakfast that is filled with good fats (for example, avocado or coconut milk), as well as a good source of protein, while limiting your intake of sugars (even from fruit). Some options include eggs with avocados, burger patties, or protein and fat-based smoothies. In addition to a good breakfast, eating frequent protein and fat-containing meals and snacks, help to balance your blood sugar throughout the day.

Eat on a schedule to avoid getting “Hangry”

It’s ideal to eat every two to three hours, and avoid high carbohydrate foods, to support balanced blood sugar. This will also help with energy levels, feelings of anxiety, and “hanger”. A typical day would look like this:

Start the day with an energizing Adrenal Kick Start (recipe is in the book), followed by a blood-sugar-balancing breakfast smoothie.
A mid-morning snack/caffeine-free latte/tea/green juice to help with blood sugar, hunger, hormones, and energy levels.
A nourishing and balancing midday lunch.
Another snack/caffeine-free latte/tea/green juice two to three hours later.
An easy-to-digest dinner is scheduled for the early evening to set up for restful sleep.
An optional after dinner snack or tea, to support restful sleep through stable blood sugar levels at night.

Reduce (and ideally eliminate) caffeine

If you’re currently drinking coffee, soda, green tea, or black tea, removing or reducing your intake of caffeine can be helpful for an immediate reduction in anxiety, and is supportive over time to your adrenals.

Some people who are slow metabolizers of caffeine and do not clear it effectively out of their body may not be able to have any caffeine at all – not even chocolate! Others who are fast metabolizers and are able to clear caffeine more quickly from their bodies, may be able to tolerate more daily caffeine without it impacting their anxiety levels.

Regardless of your genes and metabolism of caffeine, the weaker your adrenals and the more unbalanced your blood sugar levels are, the more likely you are to experience anxiety from caffeine. This is because caffeine forces more glucose to be produced by the liver, sending the body on a blood sugar rollercoaster that can trigger anxiety.

If you’re thinking about reducing your caffeine intake, do it gradually over time, instead of quitting cold-turkey, which can cause withdrawal symptoms such as headaches, fatigue and even vomiting.

There are ways to improve energy levels and sleep before trying to get off caffeine, such as supporting your mitochondria and tuning into the circadian rhythm.

[Trudy’s note: be sure to read my comment above about the need to eliminate caffeine altogether in many instances]

Address low magnesium

Research suggests that a magnesium deficiency may be associated with anxiety. Several studies have found that feelings of fear and panic can be greatly reduced with an increased magnesium intake.^[11] It has even been shown to have a positive effect on both post-traumatic anxiety and premenstrual anxiety, as well.^[12]

Even more interesting, is the understanding that magnesium also controls the hypothalamic-pituitary-adrenocortical (HPA) axis, which is the hub of the body’s stress response system.^[13] This could provide some explanation as to why a magnesium deficiency could lead to increased stress and anxiety when the HPA axis is out of balance. Other signs of a magnesium deficiency include headaches, insomnia, constipation, and menstrual cramps.

A magnesium supplement throughout the day may help, or at bedtime if you have insomnia or a racing mind when you’re trying to fall asleep. The citrate version is best if you tend to be constipated (magnesium citrate has stool softening effects), and I recommend the glycinate version if you tend to have normal bowel movements or diarrhea. Keep in mind that, for some people, magnesium glycinate can worsen anxiety symptoms. If you notice that your anxiety increases after taking magnesium glycinate, try switching to magnesium citrate.

Remove reactive foods

The most common food reactions responsible for anxiety symptoms are due to gluten, dairy, soy, grains (especially corn), sugar, caffeine (as discussed above), and surprisingly to some, nuts.^[14]

Doing targeted food sensitivity testing, or simply a trial of eliminating the suspect foods for a period of time (with an elimination diet), can help you uncover your food triggers.

If anxiety is not resolved using the strategies above, there are many advanced strategies for anxiety support, and the book provides plenty of information and options for testing.

Address copper toxicity

A toxic buildup of copper may be at the root of anxiety, racing thoughts, mood swings, fatigue, and insomnia.^[15] High-copper foods include shellfish, oysters, nuts, seeds, and chocolate. We can also absorb copper from our water and metal pipes and products. Certain medications (oral contraceptives, antacids, copper-rich multivitamins), excess estrogen, copper IUDs, and zinc deficiency can increase our exposure. Many people with adrenal dysfunction have a congested liver, so that is likely one reason copper toxicity is a common root cause.

Reducing copper containing foods, and increase zinc containing foods (non-organ meats, eggs, poultry).

Balance thyroid hormones

Having an excess amount of thyroid hormone can make us extremely anxious, irritable and on edge. This is commonly attributed to Graves’ disease, but can also occur in Hashimoto’s. The ideal TSH for most people is between 0.5-2 μIU/mL. Levels that are too high or too low indicate an imbalance of thyroid hormone levels and have been associated with various symptoms, including anxiety. Work with your doctor to test your thyroid and adjust medication if needed.

Address female hormone imbalances

Estrogen dominance and/or low progesterone may lead to many symptoms like irritability, mood lability, depression, and mood swings.^[16] If tests reveal low progesterone, supplementing with oral or topical bioidentical progesterone might just be the chill pill you need.

Address gut infections

An imbalance of gut bacteria can contribute to mood issues. There are also certain overgrowths and gut infections that can impact anxiety levels. For example, overgrowth of Streptococcus bacteria has been associated with obsessive-compulsive disorder.^[17] The book includes recommendations for further testing that can help you determine if you have an overgrowth or infection.

Address iron toxicity/overload

A buildup of too much iron can cause irritability and depression.^[18] Ferritin levels above 200 ng/dL in women (300 ng/mL in men) can indicate iron toxicity or overload. The book offers several different options for treatment.

Address mold toxicity

There is a big connection between mood issues and mold exposure.^[19] If your symptoms appeared or increased after moving into a new home, there’s a good chance your anxiety may be connected to mold exposure.

Address common nutrient deficiencies

Nutrient deficiencies are common in those with adrenal issues, and could be contributing to feelings of anxiety. Address these important nutrients for mood support: omega-3 fatty acids, folate (vitamin B9), iron, vitamin B12, and vitamin D.

Address the social anxiety condition called pyroluria

Symptoms of social anxiety have been associated with pyroluria, which is a condition where there are too many pyrrole molecules in your body.^[20] These molecules can deplete your system of essential nutrients that play an important role in mood and adrenal health.

[Trudy’s note: I’m really pleased to see pyroluria mentioned in this book, because it’s not often acknowledged as a condition. I also appreciate the reference, in the pyroluria section, to my work and book, The Antianxiety Food Solution.]

Adrenal Transformation Protocol – for anxiety

Adrenal Transformation Protocol (my Amazon link) provides comprehensive support for the many potential stressors the body can experience, so that you can heal anxiety using a whole body, root-cause approach.

When we address the root causes of adrenal fatigue and anxiety, like blood sugar imbalances, food sensitivities, and nutrient deficiencies, we can increase our resilience and reduce feelings of anxiety!

Adrenal dysfunction often begins after a stressful period in our lives. When the body puts cortisol front and center, rebuilding and repairing go on the backburner, and we can end up with a host of symptoms including fatigue, brain fog, and anxiety.

While most people can bounce back from small stressors, some of us can get caught up in a stress cycle that ends up affecting our physiology. When we are caught in this stress cycle, it throws our hormonal systems out of balance, and leads to us being stuck in “fight or flight” mode. Prolonged “fight or flight” mode eventually leads to burnout, and often contributes to anxiety.

Through years of research, patient study, and work with thousands of clients, my signature protocol has been shown to reverse symptoms of adrenal fatigue. It provides a foundation for optimal health, and can even be one of the keys to resolving anxiety.

In both my own work and Izabella’s, we have found that addressing the adrenals often results in the complete resolution of chronic stress symptoms!

Izabella has experienced multiple bouts of adrenal fatigue and has struggled with anxiety. She realized that her body was responding to the various stress triggers in her environment, and decided to send it safety signals instead, to put it into a healing and rebuilding state. The protocol worked so well for her that she piloted it as a program with a small group in 2020. Despite all of the things that happened in 2020, people reported that the program helped them rebalance their stress response.

Over 3000 people have now completed this protocol, with incredible results, and it’s all in her new book, Adrenal Transformation Protocol (my Amazon link). The book outlines a simple four-week plan to help you recover your adrenal function and resolve symptoms like fatigue, brain fog, depression, and anxiety. The protocol is designed to help you feel calm, strong, excited about life, and brilliant once more!

In addition to reduced brain fog, reduced fatigue, and better sleep, participants reported incredible results in mood – 86 percent reported reduced anxiety and 80 percent reported reduced feelings of nervousness.

Adrenal dysfunction can be a root cause of anxiety. If you’re still experiencing anxiety symptoms and feel like you’ve tried everything, but haven’t yet addressed your adrenal health, I’d highly recommend Adrenal Transformation Protocol (my Amazon link)!

Feel free to share your feedback once you’ve read the book.

Also, let us know if any of the above approaches have helped you address your adrenal issues?

If you have questions and other feedback please share it here too.

^[1] Cook SB. Current Controversy: Does Adrenal Fatigue Exist?. Natural Medicine Journal. 2017;9(10).^[2] Faravelli C, Lo Sauro C, Lelli L, et al. The role of life events and HPA axis in anxiety disorders: a review. Curr Pharm Des. 2012;18(35):5663-5674. doi:10.2174/138161212803530907

^[3] Carta M, Loviselli A, Hardoy M et al. The link between thyroid autoimmunity (antithyroid peroxidase autoantibodies) with anxiety and mood disorders in the community: A field of interest for public health in the future. BMC Psychiatry. 2004;4(1). doi:10.1186/1471-244x-4-25.

^[4] Lopresti AL, Smith SJ, Malvi H, Kodgule R. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2019;98(37):e17186. doi:10.1097/MD.0000000000017186

^[5] Dongre S, Langade D, Bhattacharyya S. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study. Biomed Res Int. 2015;2015:284154. doi:10.1155/2015/284154

^[6] Lee Y, Jung JC, Jang S, et al. Anti-Inflammatory and Neuroprotective Effects of Constituents Isolated from Rhodiola rosea. Evid Based Complement Alternat Med. 2013;2013:514049. doi:10.1155/2013/514049

^[7] Cropley M, Banks AP, Boyle J. The Effects of Rhodiola rosea L. Extract on Anxiety, Stress, Cognition and Other Mood Symptoms. Phytother Res. 2015;29(12):1934-1939. doi:10.1002/ptr.5486

^[8] Pan L, Jaroenporn S, Yamamoto T, et al. Effects of pantothenic acid supplement on secretion of steroids by the adrenal cortex in female rats. Reprod Med Biol. 2011;11(2):101-104. Published 2011 Dec

^[9] Valdés F. Vitamina C [Vitamin C]. Actas Dermosifiliogr. 2006;97(9):557-568. doi:10.1016/s0001-7310(06)73466-4

^[10] Mathew P, Thoppil D. Hypoglycemia. In: StatPearls. Treasure Island (FL): StatPearls Publishing; July 23, 2022.

^[11] Boyle NB, Lawton C, Dye L. The Effects of Magnesium Supplementation on Subjective Anxiety and Stress—A Systematic Review. Nutrients. 2017 May; 9(5): 429. doi:10.3390/nu9050429.

^[12] Fromm L, Heath DL, Vink R, Nimmo AJ. Magnesium attenuates post-traumatic depression/anxiety following diffuse traumatic brain injury in rats. J Am Coll Nutr. 2004;23(5):529S-533S. doi:10.1080/07315724.2004.10719396

^[13] Sartori SB, Whittle N, Hetzenauer A, Singewald N. Magnesium deficiency induces anxiety and HPA axis dysregulation: modulation by therapeutic drug treatment. Neuropharmacology. 2012;62(1):304-312. doi:10.1016/j.neuropharm.2011.07.027

^[14] Vatn MH. Food intolerance and psychosomatic experience. Scand J Work Environ Health. 1997;23 Suppl 3:75-78.

^[15] Russo AJ. Decreased zinc and increased copper in individuals with anxiety. Nutr Metab Insights. 2011;4:1-5. Published 2011 Feb 7. doi:10.4137/NMI.S6349

^[16] Glick ID, Bennett SE. Psychiatric complications of progesterone and oral contraceptives. J Clin Psychopharmacol. 1981;1(6):350-367. doi:10.1097/00004714-198111000-00003

^[17] Mell LK, Davis RL, Owens D. Association between streptococcal infection and obsessive-compulsive disorder, Tourette’s syndrome, and tic disorder. Pediatrics. 2005;116(1):56-60. doi:10.1542/peds.2004-2058

^[18] Cutler P. Iron overload and psychiatric illness. Can J Psychiatry. 1994;39(1):8-11. doi:10.1177/070674379403900104

^[19] Harding CF, Pytte CL, Page KG, et al. Mold inhalation causes innate immune activation, neural, cognitive and emotional dysfunction. Brain Behav Immun. 2020;87:218-228. doi:10.1016/j.bbi.2019.11.006

^[20] Mensah A. Mood instability: Pyrrole disorder underlying cause bipolar, DMDD. Mensah Medical. https://www.mensahmedical.com/pyroluria-pyrrole-disorder/. Published July 12, 2016. Accessed February 8, 2023.

Multiple sclerosis: low GABA research and the amino acid GABA for anxiety, muscle stiffness, swallowing/voice issues and pain

April 14, 2023 By Trudy Scott 12 Comments

I’m excited about the GABA research – an older paper and some new studies – on multiple sclerosis (MS). This means there is the potential for using GABA supplementation in similar ways it’s used with other conditions where anxiety, insomnia and pain are issues. This can include the typical low GABA-type physical anxiety, stiff and tense muscles, insomnia and pain, and also MS-specific issues such as spasticity, laryngospasms, balance issues, swallowing and speaking/voice issues and sensorimotor problems.

Anxiety is common in MS and benzodiazepines are commonly prescribed. The ideal is to use the amino acid that supports GABA, instead of needing to use benzodiazepines. I share some of the GABA/MS research and specific applications for using GABA below.

Prevalence of anxiety/depression in MS and the use of benzodiazepines

Anxiety and depression is common in multiple sclerosis. This paper, The incidence and prevalence of psychiatric disorders in multiple sclerosis: A systematic Review, included 118 studies and found that:

Among population-based studies, the prevalence of anxiety was 21.9% (and up to 35.0% in some papers), 23.7% for depression, 14.8% for alcohol abuse, 5.83% for bipolar disorder, 4.3% for psychosis and 2.5% for substance abuse.

psychiatric comorbidity remains understudied.

What is concerning is that benzodiazepines such as Ativan, Valium and Xanax are commonly prescribed for MS patients for their anxiety, insomnia, spasticity and pain. Recent research, Use of Benzodiazepines and Z-Drugs in Multiple Sclerosis found that benzodiazepine use is more “more common in people with MS than in general population controls, and use of these agents is in persons with MS is often chronic” i.e. for longer than 6 months.

This is problematic given that anything over 2 weeks can cause dependence, tolerance and withdrawal. They can cause balance issues and can actually cause anxiety and insomnia. Someone in my community was totally disabled for over 3 years with “locked shoulder muscles, neck, jaw …internal vibrations… bad headaches, jelly legs, distorted vision like floaters and squiggles and fireworks …cortisol rushes through the body.. And tortured every day.” Read more about her horror story and benzos here.

The ideal is to use the amino acid that supports GABA, instead of needing to use benzodiazepines.

Low GABA plays a role in multiple sclerosis: the research

Low GABA (gamma-aminobutyric acid) plays a role in multiple sclerosis. This paper, Reduced gamma-aminobutyric acid concentration is associated with physical disability in progressive multiple sclerosis states that there are

reduced GABA levels in the hippocampus and sensorimotor cortex of patients, and show that reduced GABA in the sensorimotor cortex is associated with increased motor impairment. Changes in GABA may be a marker of neurodegeneration.

This study supports the idea that modulation of gamma-aminobutyric acid neurotransmission may be an important target for neuroprotection in multiple sclerosis.

Of course, the authors don’t mention using the calming amino acid GABA, but we extrapolate and use what we see clinically in other conditions like autism (more on that below).

Two other papers support the GABA connections. This 2021 paper, Altered Plasma Metabolic Profiles in Chinese Patients With Multiple Sclerosis, observed “a great increase in the levels of L-glutamic acid” in patients with MS. Increased glutamate typically means low GABA levels.

Guanidinoacetic acid (GAA) is an experimental nutrient that is new to me, but the GABA effects and mechanisms are encouraging. In this 2022 paper, Guanidinoacetic Acid as a Nutritional Adjuvant to Multiple Sclerosis Therapy the author states that GAA may benefit MS patients via “modulation of gamma-aminobutyric acid (GABA)ergic neurotransmission and brain oxidant-antioxidant status, or a reduction of glutamate neurotoxicity.’

The author also shares that “demyelination is often characterized by various neurochemical abnormalities in GABA-glutamate metabolism.”

In case you’re new to MS and demyelination, this Mayo Clinic article describes them as follows:

A demyelinating disease is any condition that causes damage to the protective covering (myelin sheath) that surrounds nerve fibers in your brain, the nerves leading to the eyes (optic nerves) and spinal cord. When the myelin sheath is damaged, nerve impulses slow or even stop, causing neurological problems.

Multiple sclerosis is the most common demyelinating disease of the central nervous system. In this disorder, your immune system attacks the myelin sheath or the cells that produce and maintain it.

This attack causes inflammation and injury to the nerve sheath and ultimately to the nerve fibers that it surrounds. The process can result in multiple areas of scarring (sclerosis).

Using GABA for easing anxiety, overwhelm and insomnia in multiple sclerosis

There is no research that I am aware of that has studied the use of GABA supplementation in MS. We can, however, extrapolate from other conditions and use GABA for easing various MS symptoms based on what we see clinically.

As mentioned above, anxiety is common in MS and if you have the low GABA type of physical anxiety, GABA is worth a trial for easing typical low GABA symptoms of physical anxiety, feelings of overwhelm and intrusive thoughts, stress eating, using alcohol to relax or fit in socially and insomnia. You can read more about GABA for physical anxiety here and see all the low GABA symptoms here.

And here are a few examples/case studies:

Using GABA to help with balance, and sensorimotor and coordination issues in multiple sclerosis

These case studies illustrate an application for GABA being used for balance, sensorimotor and coordination issues that are common in MS (they are not folks with MS):

Much of the research in this area has been done with autism, as illustrated by this GABA Oolong tea study tea in children with autism. They saw improvements in sensorimotor skills, autism profiles, anxiety and sleep.

Using GABA to help with stiff and tense muscles, spasticity, voice issues, laryngospasms and difficulty swallowing in multiple sclerosis

GABA helps to ease stiff and tense muscles in those with physical anxiety. In a similar way we see GABA help with these common MS symptoms: muscle spasms, spasticity, voice issues, laryngospasms and swallowing difficulties (dysphagia affects about a third of folks with MS).

These case studies illustrate an application for GABA being used for some of above issues that are common in MS (they are not folks with MS):

Again, there is no research that I am aware of specifically with MS, but clinically I see GABA helping all of the above symptoms related to spasms and muscle tension, often with anxiety and pain as an underlying factor too.

Other MS symptoms that may also be supported by addressing low GABA levels: bowel issues and rectal spasms, bladder issues/spasms, tremor and problems with memory/thinking, and possibly even vision issues.

I really look forward to seeing future research on the use of the amino acid GABA in MS. And I’d love to be involved in some studies if you are associated with a research facility or do research.

Low serotonin and low endorphins are common in multiple sclerosis too

Low GABA is just the tip of the iceberg when it comes to the underlying neurotransmitter imbalances in MS.

The amino acid DPA/d-phenylalanine may help ease some of the low endorphin pain symptoms, weepy kind of depression, and alcohol addiction. You can read about this here.

Tryptophan and/or 5-HTP may help ease some of the low serotonin worry-type of anxiety, fear, panic attacks, obsessing, low mood and MS-specific pain issues and insomnia. I’ll write more about this and the supporting research in a follow-up blog.

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

If you are new to using GABA and 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, low serotonin and low endorphins).

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, anxiety and mood issues.

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.

Do you have multiple sclerosis and has the amino acid GABA helped with your anxiety and fears; muscle stiffness and spasticity; swallowing, laryngospasms and voice problems; balance and sensorimotor issues, insomnia and pain?)

How much has helped and which product do you use?

Do you find sublingual, powder or an opened capsule helps more than swallowing the GABA capsule?

Were you surprised that GABA would help so much?

What else has helped your multiple sclerosis symptoms? And have you also addressed low serotonin and low endorphins with amino acids tryptophan and DPA?

If you have questions and other feedback please share it here too.

Her mum just passed away and although she is sad, GABA allows her to sit with a feeling of peace and calm most of the time

April 7, 2023 By Trudy Scott 33 Comments

Sandra shared this heartening feedback on how GABA helped right after the passing of her mum. She also voiced her surprise that it could have such a profound effect at a sad time like this, asking me if this was possible:

I recently started taking GABA Calm lozenges. I settled on a small dose of one lozenge at bedtime. Initially I took this for tense neck and shoulder muscles due to years of anxiety.

What I have noticed in the past month is that I seem quite calm although I do still have tense neck muscles.

Last week I experienced a profound bereavement with the passing of my mum who I have been caring for. I am genuinely surprised at how I have handled this stressful situation including the funeral. I have always been quite emotional and I have found myself, although sad, sitting in a feeling of peace and calm most of the time.

Is it possible that the GABA Calm is contributing to this? It was my understanding this product would assist with my tense muscles but I feel like it has helped me tremendously with my mindset, emotions and mood.

I look forward to your reply.

I offered my condolences for the loss of her mum and said how heartened I felt, hearing that she had a feeling of peace and calm most of the time. And the fact that GABA had helped with the stressful events of the funeral and her mindset, emotions and mood. I would expect the feeling of peace and calm, and helping reduce overall stress. The calming amino acid supplement, GABA, has long been recognized to help ease the more physical type of anxiety.

But because the amount of GABA she was taking didn’t help with her tense muscles, some of the benefits may have been as a result of GABA reducing the distressing unwanted thoughts. The emotions and mood are added benefits that we don’t always hear about with GABA but are not unheard of (more on this below).

I thanked Sandra for sharing this wonderful feedback, letting her know I’d share it as a separate blog, so we can offer support to others in similar situations. I’ll also be sharing this blog with her so she understands some of the mechanisms better too. In fact, I only made the unwanted thoughts connection after having responded to her.

GABA helps with inhibition of unwanted thoughts

In the past I’ve blogged about how Scientists identified a mechanism that helps us inhibit unwanted thoughts:

We are sometimes confronted with reminders of unwanted thoughts – thoughts about unpleasant memories, images or worries. When this happens, the thought may be retrieved, making us think about it again even though we prefer not to. While being reminded in this way may not be a problem when our thoughts are positive, if the topic was unpleasant or traumatic, our thoughts may be very negative, worrying or ruminating about what happened, taking us back to the event.

Scientists have identified a key chemical within the ‘memory’ region of the brain that allows us to suppress unwanted thoughts, helping explain why people who suffer from disorders such as anxiety, post-traumatic stress disorder (PTSD), depression, and schizophrenia often experience persistent intrusive thoughts when these circuits go awry.

Professor Anderson, Dr. Schmitz and colleagues showed that the ability to inhibit unwanted thoughts relies on a neurotransmitter – a chemical within the brain that allows messages to pass between nerve cells – known as GABA.

GABA is the main ‘inhibitory’ neurotransmitter in the brain, and its release by one nerve cell can suppress activity in other cells to which it is connected.

Anderson and colleagues discovered that GABA concentrations within the hippocampus – a key area of the brain involved in memory – predict people’s ability to block the retrieval process and prevent thoughts and memories from returning.

You can read more on the blog post here: GABA helps with inhibition of unwanted thoughts

If you are using the GABA with success already and experience the loss of a loved one, you may find you need to increase your dose for a period of time.

There is individual variability in the capacity to cope with stress during bereavement

Research supports that there is “individual variability in the capacity to cope with stress” during bereavement and there are differences in symptoms and physiological changes. This paper, Long-term immune-endocrine effects of bereavement: relationships with anxiety levels and mood, identified changes in depression, anxiety, adrenocorticotropin and cortisol plasma concentrations, beta-endorphins, and reduced “functional activity of natural killer cells.” And the two different groups of people in the study had different symptoms and physiological changes.

GABA and glutamate, and the HPA axis in depression/bereavement

The above paper doesn’t mention GABA but growing evidence indicates that glutamate and GABA, and the HPA axis/corticotropin-releasing hormone, plays a role in depression and presumably bereavement too. This may be another mechanism that led to the feelings of calm that Sandra experienced.

You’ll need to figure out your unique biochemical needs

When you experience the loss of a loved one, you’ll need to figure out your unique biochemical needs and address them one by one. You may need GABA support like Sandra and/or may find you need serotonin support (with tryptophan or 5-HTP) and/or may need endorphin support (with the amino acid DPA/d-phenylalanine).

Both GABA and serotonin support also helps to address sleep problems. DPA helps especially with the emotional pain and weepiness, and if you’re self-medicating with comfort foods while grieving.

If you have high cortisol you may benefit from Seriphos or Lactium.

Keep in mind that nutritional support is immensely helpful during caregiving too. Here is just one example: When using the amino acid DPA (d-phenylalanine) I have more resilience and more buffer in the caregiving work I do, and just the oops’s of life

Helping Sandra ease her still tense neck muscles

For her ongoing tense neck and shoulder muscles I suggested a higher amount of GABA may be needed. She reported back that taking it in the morning made her sleepy and a couple of times she noticed a headache.

When GABA in the day causes sleepiness I have clients use less GABA more frequently or to take more at night to carry over the next day. In this case probably a GABA-only product because of her headaches.

She did share that GABA was her starting point with the intention of including tryptophan for ruminating and fearful thoughts which do stop her from participating in various activities. Low serotonin does cause TMJ (temporomandibular joint) pain and it’s possible this is contributing to her ongoing tense neck and shoulder muscles, and tryptophan may be the solution.

We also address low magnesium if applicable. I’d also suggest looking into dietary oxalates too and getting checked for physical issues by a chiropractor and/or osteopath and/or physical therapist.

You can read our discussion on this blog.

Resources if you are new to using GABA or tryptophan or DPA as supplements

If you are new to using GABA or tryptophan or DPA 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, low serotonin and low endorphins).

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, anxiety and mood issues (which include rage/anger/irritability/self-harm).

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.

Has GABA or tryptophan or DPA helped you after the loss of a loved one? How did each one help?

Were you surprised that they would help so much?

If you were using the aminos with success already did you find you needed to increase your dose for a period of time?

What else has helped you at a time of loss?

If you have questions and other feedback please share it here too.