Archives for June 2023

GABA helps ease symptoms of anger, rage, and dark moods (symptoms we typically associate with low serotonin)

June 30, 2023 By Trudy Scott 23 Comments

As a result of this wonderful feedback from a mom in the online GABA QuickStart program, I’ve been looking into GABA-anger connections. I’ve been trying to understand how GABA could offer similar benefits to tryptophan/5-HTP for anger, rage and dark moods, which we typically associate with low serotonin. She shares this:

My son who is 19 and on the autism spectrum was having issues with outbursts of anger and stuttering. These issues seemed to worsen during his senior year of high school. Since starting GABA and tailoring his dosage from Trudy’s instruction and feedback, we have seen a 90% reduction in stuttering and 80% reduction in anger and outbursts. We have done many supplemental protocols over the years and this is one of the few we have seen have an impact.

I am so happy for this young man and his family, and was also very intrigued. I’ve seen GABA help with stuttering. I have not noticed that GABA helps very much with anger/rage in clients but possibly because they are making other changes at the same time. Since they were in the program and he also had anxiety, we decided to continue with GABA.

I worked with them in the program over a few months and know he only changed one thing – GABA, starting low and increasing to find his ideal dose (with my guidance).

So I started to dig into the research, search through prior blog posts and ask on Facebook and the feedback is robust – folks are seeing GABA help with symptoms of anger and rage.

I share a few case studies below: how PharmaGABA helps a 9 year old boy with rages (part of his OCD/PANS), how GABA helps a young boy with Lyme-induced anger and how GABA helps a 9 year old girl with anger and dark moods (part of her PCOS).

I also share my insights with each case. And some possible mechanisms because we always want to understand why.

PharmaGABA helps 9 year old with rages that are part of his OCD/PANS

Kathy shares how pharmaGABA helped her son (on a pharmaGABA blog):

My 9 year old son had a lot of benefits from PharmaGABA. He used to have rages as part of his OCD/PANS. PharmaGaba 3 times a day was a miracle to get him through that period.

PANS is a neuropsychiatric disorder that falls under the same umbrella as PANDAS but is triggered by an infection other than strep.

If you’re new to PANS/PANDAS, I share the definition of PANDAS, from the PANDAS Network, in this blog: “PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) occurs when strep triggers a misdirected immune response that results in inflammation on a child’s brain. In turn, the child quickly begins to exhibit life changing symptoms such as OCD/obsessive compulsive order, anxiety, tics, personality changes, decline in math and handwriting abilities, sensory sensitivities, restrictive eating, and more.”

Both PANS and PANDAS trigger OCD/obsessive compulsive disorder. OCD is typically supported with tryptophan and/or inositol i.e. these obsessive thinking and behaviors are typically related to low serotonin even when there is an infection involved. The infection needs to be addressed but the tryptophan and/or inositol help to ease the obsessive symptoms.

Rage is a common symptom when serotonin is low. Tryptophan addresses low serotonin and can have a huge impact as I share in this blog – Rage, anxiety, cravings & insomnia in 11-year old girl with RAD/reactive attachment disorder: chewable tryptophan turns things around.

However, in this instance, pharmaGABA worked for the rages Kathy’s son experienced.

PharmaGABA is one form of GABA that has been shown to help with relaxation and anxiety.

GABA helps a young boy with Lyme-induced anger

Another mom shared this on a Lyme disease post on Facebook:

One kid has developed fits of anger that come out of nowhere but the GABA seems to be able to help him to play longer periods.

Lyme disease can also have a neuropsychiatric aspect, as shared by Dr. Suruchi Chandra MD. I’ve had the pleasure of interviewing Dr. Chandra on one of the Anxiety Summits and hear her present at integrative mental health conferences.

In one conference presentation she shared this: “Lyme disease is one of the fastest growing infectious diseases in the United States. It can remain dormant for years and then later mimic a number of psychiatric illnesses, including anxiety disorders, mood disturbances, psychosis, and autism-like behaviors. It can be further complicated by the presence of co-infections.”

Anger and rage are also common symptoms. In one study, “Lyme rage” is described as an anger episode that “had a very abrupt onset and was extremely intense and often with minimal cognitive control.”

Yet again, we often see GABA help ease some of the anxiety symptoms, as I share here – GABA helps with Lyme anxiety (while addressing the underlying disease).

However in this instance, GABA helped with her son’s anger symptoms induced by the Lyme bacteria.

GABA helps a 9 year old girl with anger and dark moods (part of her PCOS)

Debbie was diagnosed with PCOS (polycystic ovarian syndrome) and GABA helped ease her lifelong anxiety, wean off anxiety medication, ovulate each month and stop her PCOS medications. She was thrilled that GABA helps her daughter too. She shared how her oldest daughter who is 9 has been showing early signs of developing PCOS and other issues similar to hers:

When her mood started changing and she was getting angry out of nowhere and very dark and moody, I started her on a small dose of GABA. Immediately both of us saw the difference in her mood. She now asks for her “happy pills” daily because she doesn’t want to feel those dark feelings anymore. I wish this information was around when I was young. It could’ve helped so much of what I had to struggle with for years.

I typically think of tryptophan or 5-HTP as “happy pills”, and anger and a dark mood as symptoms of low serotonin.

However, yet again, GABA resolves these symptoms in Debbie’s daughter.

These are just a few of the many recent success stories I’ve heard about GABA and anger/rage.

Does low GABA anger/rage look different from low serotonin anger-rage?

This is all new to me so I honestly don’t know. We do know that low GABA leads to more of a physical kind of anxiety (i.e. felt in the body) and it’s different from low serotonin worry-type anxiety (i.e. it’s felt in the head).

Therefore, it’s possible that low GABA anger and rage has more of a physical aspect too.

I have yet to explore this aspect but feel it may be helpful to figure out if there is a difference in order to effectively use the neurotransmitter symptoms questionnaire. This questionnaire is used to decide whether to trial GABA or tryptophan/5-HTP and the low GABA section will be updated with anger/rage once I’ve gone a bit deeper with all this.

The kind of anger symptoms may well look the same and then we’ll use the clustering of either low GABA or low serotonin symptoms to base our decision for doing an amino acid trial.

Research: GABA may be critical in the neurochemical control of aggressive behavior and rage

There is no research that I am aware of where the amino acid GABA has been used to ease rage, anger or dark moods.

However, this letter, Tiagabine for Rage, Aggression, and Anxiety published in the Journal of Neuropsychiatry and Clinical Neuroscicnes in 2015 offers some round-about support to this GABA-rage observation. They are discussing patients with treatment-resistant rage and aggression and they propose that:

Gamma-aminobutyric acid (GABA), the primary inhibitory neurotransmitter, may be critical in the neurochemical control of aggressive behavior.

They share that the prescription medication called Tiagabine, a selective GABA reuptake inhibitor (SGRI), increases synaptic GABA availability.

And that 20 out of 36 patients aged 15-54 years (69%)

with symptoms of rage, aggression, or anxiety in association with one or more of the following disorders: bipolar, intermittent explosive, major depression, panic disorder, attention deficit hyperactivity disorder, or substance abuse …demonstrated a good or excellent response to tiagabine, with reduction or elimination of the symptoms of rage, aggression, or anxiety.

This and the few studies on anger and glutamate (like this one) offer the most plausible explanations for the quick results we expect when using GABA and other amino acids i.e. quick as in results in 1-30 minutes.

Other than this there is not much direct evidence supporting this GABA-rage connection. GABA likely also helps quickly because of reduced anxiety, improved sleep, and being easil able to quit or eat less sugar (and in adults quit alcohol).

Based on some research I’ve found and my experience with GABA, I suspect GABA may also help in these ways over a longer period: countering a histamine reaction, reducing inflammation and impacting cytokines, improving progesterone levels, beneficial impacts on the microbiome, supporting the liver and toxin removal (such as fluorides), gut healing and reducing high blood pressure. I am still digging into the research.

I thank these families for sharing their stories so we all benefit.

I also really appreciate this opportunity to learn from you – my community – and I will always strive to keep an open mind.

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 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, 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). This is a paid online/virtual group program where you get my guidance and community support. Another option is the budget-friendly GABA QuickStart Homestudy program.

[The 19 year old young man/his mother were part of an earlier version of the GABA Quickstart program].

If you also need serotonin support, the Serotonin QuickStart Program is a good place to get help. This is also a paid online/virtual group program where you get my guidance on using tryptophan and 5-HTP safely, and community support during 5 LIVE Q&A calls. You can sign up to be notified when the next live launch of this program is happening.

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.

Now I’d love to hear from you ….

Has GABA helped you or your child with symptoms of anger, rage or a dark mood? And if yes, how did it help, how much helped and which product helped?

Can you be sure GABA helped i.e. is this the only change you made?

Has serotonin support with tryptophan or 5-HTP also helped? And if yes how would you describe the low serotonin anger symptoms vs the low GABA anger symptoms? Are they different?

If you are a practitioner, have you observed any of the above?

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

Dysphoric Milk Ejection Reflex (D-MER) is an abrupt emotional “drop” that occurs in some women just before milk release

June 23, 2023 By Trudy Scott 4 Comments

Dysphoric Milk Ejection Reflex (D-MER) is an abrupt emotional “drop” that occurs in some women just before milk release and continues for not more than a few minutes. The brief negative feelings range in severity from wistfulness to self-loathing, and appear to have a physiological cause.

The authors suggest that an abrupt drop in dopamine may occur when milk release is triggered, resulting in a real or relative brief dopamine deficit for affected women.

Clinicians can support women with D-MER in several ways; often, simply knowing that it is a recognized phenomenon makes the condition tolerable. Further study is needed.

The above abstract is from this paper published in 2011 – Dysphoric milk ejection reflex: A case report.

Alia Heise (AH) is co-author of this paper and coined the term D-MER. She is sharing her breastfeeding and D-MER experiences as the case.

Many women who are struggling with these feelings don’t ask for help and when they do they are often dismissed. The authors share it’s “a breastfeeding problem for which affected mothers seem only rarely to seek or receive help.” I’m sharing this case and more about D-MER for these reasons and because troubled mothers often stop breastfeeding.

Read on to learn about the dopamine hypothesis and how Rhodiola helped Alia.

Feedback from struggling moms

The authors share this description from a struggling mom:

If you read Harry Potter they talk about the creatures that suck the soul out of you and when they are around it makes you cold and you start to focus on negative things and fall into this abyss of negative thoughts – that is how D-MER was for me at times.

Someone in my community shared this when I posted the case on Facebook:

I experienced an extreme emotional response. I would describe it as a wave of huge anxiety… almost suicidal at times but only during letdown (it lasted only a couple of minutes if that, but it was so severe.)

I started noticing it when I would pump. After I researched it I figured out there was a name for it and a reason. I never could find anyone to help me… I remember mentioning it to my doctor and she had never heard of it. I just suffered through and so my breastfeeding/pumping journey ended at 6 months.

I appreciate Alie and the authors for helping to create awareness and these moms for sharing their experiences. Hopefully this information will mean fewer moms struggle alone with D-MER and more awareness amongst practitioners.

I share some highlights below but be sure to read the entire paper here – Dysphoric milk ejection reflex: A case report.

The spectrum of D-MER symptoms and a drop in dopamine hypothesized as the cause

Here is the spectrum of D-MER symptoms (as listed in the above paper):

Depression, wistfulness, homesickness, apprehension, hopelessness, hollowness in stomach (first 3 months)
Anxiety, dread, panic, irritability (6 to 12 months)
Anger, tension, agitation, paranoia (until weaning)

A drop in dopamine is hypothesized as the cause in susceptible mothers (also from the above paper):

Based on AH’s experiences, and until more is known, it is the authors’ very humble hypothesis that a drop in dopamine either facilitates or parallels each oxytocin spike in lactating human mothers, and that it is this dopamine drop that results in D-MER in susceptible mothers.

What adds value to Alia’s dopamine hypothesis is that bupropion, a dopamine reuptake inhibitor (i.e. a medication that increases dopamine), reduced her symptoms in a day and eliminated her symptoms in 5 days. She did, however, have to stop the medication due to side effects.

Rhodiola prevents the breakdown of dopamine, increasing it’s availability

Alia then learned about a herb called Rhodiola rosea that “is a monoamine oxidase inhibitor that prevents the breakdown of dopamine, increasing its availability.”

When she used Rhodiola her symptoms became much milder and when she missed taking Rhodiola her D-MER symptoms were worse. She didn’t notice any changes in her milk supply.

I will add that Alia used Rhodiola when her daughter was 14 months old and her D-MER symptoms were “somewhat reduced, but still extremely troublesome.” I have to wonder if she may have needed to use a higher dose when her daughter was a new-born and Alie’s symptoms were more severe.

Safety of Rhodiola when breastfeeding

The authors quote Sheila Humphrey, author of The Nursing Mother’s Herbal (my Amazon link) who groups Rhodiola with several other “tonic herbs” for which “there are no anecdotes, as yet, to suggest that they will affect breastfeeding babies.”

Dr Aviva Romm, MD, calls Rhodiola “The Spirit Calming, Anti-Anxiety Adaptogen” in this article about adaptogenic herbs

Rhodiola extract helps promote a calm emotional state and supports strong mental performance, optimal immune function, and hormonal balance. It is a key adaptogen for reducing anxiety. It improves mental and physical stamina, improves sleep, and reduces stress, “burn out,” and irritability.

She says to avoid Rhodiola if you have bipolar disorder and during pregnancy (due to lack of safety data), but considers it safe while breastfeeding.

But, as always, when it comes to nursing, I have clients work with their practitioner.

Future research on tyrosine and theanine during breastfeeding, and prevention

I would also love to see future research on the safety of tyrosine and theanine (and all amino acids) being used during breastfeeding, as another option for moms with D-MER.

Tyrosine is well-recognized as an amino acid that helps to boost dopamine levels and improve a low mood and may help ease some of the D-MER symptoms. Some individuals report how tyrosine also alleviates their anxiety and panic attacks and creates a feeling of calm focus.

Theanine, also an amino acid, supports GABA, dopamine and serotonin and I feel has a potential application in D-MER. There may well be a role for tryptophan (for serotonin support and the depression/self-loathing/anger/agitation/panic symptoms of D-MER) and GABA (for GABA support and the anxiety/tension symptoms of D-MER).

They may also help with postpartum anxiety, depression, OCD and intrusive thoughts.

I’d also like to see future research look at possible correlations between D-MER and low neurotransmitters before pregnancy/nursing. And if these women saw benefits with amino acids. Addressing low levels of neurotransmitters and the dietary factors I address in my book, The Antianxiety Food Solution, may help prevent this or at least reduce the severity of symptoms.

Resources if you are new to using amino acids as supplements

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 too). This is a paid online/virtual group program where you get my guidance and community support.

Have you experienced D-MER and were you advised to use Rhodiola? And if yes, how did it help? What else helped?

Or did you get no help from your medical team?

Do you feel there is a possible correlation between your D-MER symptoms and low neurotransmitter symptoms you experienced before pregnancy/nursing? If yes, which amino acids helped you before you were pregnant?

If you are a practitioner, are you familiar with D-MER and have you seen Rhodiola help?

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

“A catatonic woman awakened after 20 years. Her story may change psychiatry.” (Her schizophrenia was an untreated autoimmune disease)

June 16, 2023 By Trudy Scott 8 Comments

Today I’m sharing some highlights from a recent eye-opening article in the Washington Post: A catatonic woman awakened after 20 years. Her story may change psychiatry

Before she became a patient, April had been an outgoing, straight-A student majoring in accounting at the University of Maryland Eastern Shore. But after a traumatic event when she was 21, April suddenly developed psychosis and became lost in a constant state of visual and auditory hallucinations. The former high school valedictorian could no longer communicate, bathe or take care of herself.

April was diagnosed with a severe form of schizophrenia

April was hospitalized, medicated and eventually institutionalized. It got to the point where she no longer recognized her family and she became catatonic, “unmoving, unblinking and unknowing of where or who she was.”

Twenty years after April’s original diagnosis it was discovered that she has an autoimmune condition. Dr. Sander Markx is director of precision psychiatry at Columbia University and I have so much admiration for his dedication to the field and the fact that he facilitated this testing and discovery so long after meeting April, when he was a student:

Markx and his colleagues discovered that although April’s illness was clinically indistinguishable from schizophrenia, she also had lupus, an underlying and treatable autoimmune condition that was attacking her brain.

After months of targeted treatments – and more than two decades trapped in her mind – April woke up.

April’s transformation is truly heartwarming and it’s wonderful that the doctors plan to do similar testing and offer similar treatments for others living with schizophrenia who are in mental health institutions in New York State.

Researchers in other countries are making similar connections and it’s really exciting to read that they are recognizing that “underlying autoimmune and inflammatory processes may be more common in patients with a variety of psychiatric syndromes than previously believed.”

We can and should be doing better when looking for root causes

I believe we can and should be doing better when it comes to looking for root causes. Many individuals may have an autoimmune/inflammatory condition and many may have other root cause/s. If I was on an advisory panel these would be my recommendations:

Use this powerful outcome to really turn psychiatry on its head and screen for lupus and other autoimmune conditions in every single person with schizophrenia. Dr. Markx “believes highly sensitive and inexpensive blood tests to detect different antibodies should become part of the standard screening protocol for psychosis.”
Do the same for every single person with mental illnesses and illnesses with a behavioral aspect – including anxiety, depression, bipolar, OCD/obsessive compulsive disorder. ADD/ADHD, autism/ASD (autism spectrum disorders), developmental disorders and neurological disorders.
Go beyond autoimmune screening and do a comprehensive functional medicine and nutritional deficiency assessment for every single person, including low serotonin, low GABA, low vitamin D, low zinc, low vitamin B6, hormone imbalances (sex hormones, adrenals, thyroid health), gut health, liver health etc. This includes testing for infections (such as Lyme and strep), looking at toxin exposure (phthalates, mold, heavy metals) and medication side effects.

If you’re new to the concept of root causes and functional medicine/nutritional testing these two blogs will be helpful. They are specific to anxiety because I work with anxious individuals but much of it can also be applied to other mental health and even physical health conditions (like rheumatoid arthritis and say multiple sclerosis):

Functional medicine and nutrition for maintaining symptom resolution in the long term

As you read in the article, April received “short, but powerful “pulses” of intravenous steroids for five days, plus a single dose of cyclophosphamide, a heavy-duty immunosuppressive drug typically used in chemotherapy and borrowed from the field of oncology. She was also treated with rituximab, a drug initially developed for lymphoma.”

Incredibly, she recovered completely and was eventually discharged from the psychiatric hospital and has been living in a rehab center for 3 years. Unfortunately “she has recently regressed because she was not receiving adequate maintenance care.”

I see the next step for April and others like her, is maintaining resolution of symptoms in the long term. This is where functional medicine and nutrition shines.

The ISNPR shared this about Nutritional psychiatry in 2015 in a letter published in World Psychiatry, the official journal of the World Psychiatric Association:

In addition to dietary modification, we recognize that nutrient-based (nutraceutical) prescription has the potential to assist in the management of mental disorders at the individual and population level.

In other words, diet and nutrient-based approaches need to be included for mental health treatment and for prevention. One of many examples is the ketogenic diet which has been shown to reduce auditory hallucinations and delusions in those with schizophrenia. Another is the low carb diet helping to reduce bizarre intrusive thoughts. And the SMILES trial was the first randomized controlled trial to show that dietary improvement can actually treat depression.

Specific nutrients can be very powerful too. One example is a case where a woman in my community experienced a drastic reduction in intrusive thoughts, anxiety and fears (and better sleep) with GABA, tryptophan, 5-HTP and the pyroluria protocol (zinc, vitamin B6 and evening primrose oil). More on the blog. Intrusive thoughts can be alleviated with a similar combination of nutrients and by addressing hormonal imbalances too.

These blogs/research illustrate a few of the many root causes of schizophrenia and psychosis other than lupus:

When it comes to autoimmunity in general I refer you to the work of Dr. Tom O’Bryan, Dr. Izabella Wentz, Dr. Terry Wahls, Dr. Amy Myers and others who teach about using functional medicine and diet for reversing a number of different autoimmune conditions.

The above approaches can all be explored and used when individuals are initially diagnosed too. But keep in mind that there is no one size fits all and it’s a matter of finding the root causes for each person.

We are moving in the right direction and there is hope but…

We are moving in this direction, awareness is growing and there is hope. But I know we can get there sooner.

What Dr. Markx and his colleagues have discovered and shared with the world will hopefully help us get there much more quickly.

(You can read the whole story here and a similar transformation experienced by Devine Cruz.)

I’m thrilled for April and Devine and their families, and appreciate them sharing these stories with the world. Let’s hope their stories do change psychiatry!

Resources if you are new to using amino acids as supplements

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 too). This is a paid online/virtual group program where you get my guidance and community support.

Does this heartwarming story give you hope for psychiatry?

What do you feel we should be doing to advance nutritional psychiatry even more quickly?

Can you or a family member relate to this and what did you discover in terms of testing and nutritional support/functional medicine?

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

Pathological Demand Avoidance (PDA) in children with autism – how much is behavioral and how much is due to low serotonin?

June 9, 2023 By Trudy Scott 14 Comments

Pathological Demand Avoidance (PDA) is a condition associated with Autism Spectrum Disorder (ASD). It is a rare behavioral phenotype of ASD that is characterized by an overwhelming or obsessional need to resist or avoid demands, which can often lead to sensory overwhelm causing meltdowns and violent outbursts.

Although children in general may often try to avoid demands, children with PDA engage in avoidant behaviors at a greater level.

The key underlying factor is the extreme levels of anxiety associated with a loss of control, which can feel like a panic attack. Because of high levels of anxiety, they will often respond with a “No” even to tasks or activities that they normally enjoy and can spend a great deal of energy trying to gain control of situations and people.

(from an Australian PDA article: What is Pathological Demand Avoidance (PDA) and how can we address it? so I changed the spelling of behavioural and characterised to be American)

This is a typical overview of PDA and the common recommendations (as outlined in the above article) are all behavioral interventions: be an active listener and build trust, depersonalize requests, provide indirect praise, use humor and so on. Many parents find these helpful but the biochemical imbalances that trigger these behaviors are being ignored and/or there is a lack of awareness. I’d like to change this so more children and teens get quick relief.

There may be many different root causes such as low serotonin, low GABA, low blood sugar, gluten sensitivities, low zinc, low vitamin B6, low vitamin D, toxins, infections, phenols, salicylates etc. Today I’m going to discuss low serotonin and my rationale for reaching this conclusion. It’s also one of the quickest root causes to confirm (more on that below).

My rationale for proposing that Pathological Demand Avoidance (PDA) in children with autism is related to low serotonin

If we take the description above, all of these symptoms are classically found when a child (or adult) has low serotonin:

Extreme levels of anxiety
Can feel like a panic attack
Overwhelm
Meltdowns and violent outbursts
Loss of control
Spending a great deal of energy trying to gain control of situations and people (i.e. controlling)
Obsessional need to resist (any kind of obsessing is common when serotonin is low)

The second reason I suspect low serotonin with PDA is the timing of these behaviors i.e. later in the day. The article mentions that “A child with PDA can be very calm, cool and compliant at school and behave much worse at home. This is not because of incompetent parenting but because they have reached their tolerance levels and need to release that suppressed anxiety.”

This may well be a factor, however low serotonin symptoms are recognized as being more severe in the afternoon/evening when serotonin levels start to decline. If these children have low serotonin then it makes sense that these symptoms would start to increase once they get home.

My third reason is that low serotonin is common in autism/autism spectrum disorder (ASD).

Low serotonin is common in autism/autism spectrum disorder (ASD)

This paper, Vitamin D hormone regulates serotonin synthesis. Part 1: relevance for autism, summarizes it as follows: “The disruption of the serotonergic system is one of the most consistent observations associated with autism. Serotonin in the brain promotes prosocial behavior and correct assessment of emotional social cues.”

Their recommendations are vitamin D and tryptophan supplementation which they say “may be a simple method of increasing brain serotonin without negative side effects.”

Testing for low levels of vitamin D and supplementing accordingly is important.

Are there other low serotonin symptoms and using a trial of tryptophan to confirm

As mentioned above, low serotonin is also one of the quickest root causes to confirm. As always, regardless of the diagnosis, we assess for low serotonin by rating symptoms on a scale of 1 to 10 (with 10 being most severe) and do a trial of tryptophan (chewed or a capsule opened on to the tongue). You will have your answer very quickly because we rate improvements in symptoms in the next 5 to 30 minutes.

In addition to the above symptoms we also look for these: worry-in-your-head and ruminating type of anxiety, phobias, lack of confidence, depression, negativity, imposter syndrome, PMS, irritability, insomnia and afternoon/evening cravings for carbs and sugar.

Lidtke is the only brand of tryptophan that I recommend simply because I see it work so well and because of quality issues with tryptophan in the past. Here are the Lidtke tryptophan products I recommend:

Lidtke Chewable Tryptophan 100 mg is a good for doing a trial and works when lower doses are needed as with children.
Lidtke Tryptophan 500 mg can be used for doing a trial. I open the capsule and use 100mg for a child. Going forward this product is helpful when higher doses are needed, especially at night. When opened it doesn’t taste very good but can be mixed with inositol or even glutamine powder or mashed banana.

You can read more on this blog: Tryptophan for the worry-in-your-head and ruminating type of anxiety, see the full list of low serotonin symptoms here and find the tryptophan products on the supplements blog here.

If you’re new to PDA, the DSM and low serotonin/other biochemical factors

Professor Elizabeth Newson was a developmental psychologist known for her work with children in the autism spectrum. This is her 2003 paper on the topic – Pathological demand avoidance syndrome: a necessary distinction within the pervasive developmental disorders

It’s not part of the DSM-5, the standard classification of mental disorders used by mental health professionals in the United States. This article, A Brief History of Pathological Demand Avoidance, offers a good backstory and shares why families want it to be part of the DSM.

Whether or not it becomes a distinct condition or autism subtype in the DSM, I’d like to see low serotonin (and likely low vitamin D) being recognized as one root cause. And acknowledging that there may be many other biochemical/nutritional approaches that should also be explored.

These symptoms are listed in the above article, in addition to avoidance behaviors, and all could fall into typical low serotonin symptoms:

verbal and physical aggression when feeling loss of control
self-injurious behavior
property destruction
refusal to participate in self-care such as bathing or brushing teeth (is this depression?)
inability to attend social events (is this fear and social anxiety?)
controlling what noises are allowed in a home, such as no music, or only certain music
inability to allow parents to have friends visit the home (is this also controlling?)
are often combative with siblings
issues with food, what to eat, when to eat, who to eat with
conflict with siblings

As mentioned above we also look into low GABA and low blood sugar (trials of GABA and glutamine will give quick confirmation too), gluten sensitivity, low zinc, low vitamin B6, toxins, infections, phenols, salicylates and so on. Of course, Nutritional and Dietary Intervention for Autism Spectrum Disorder is crucial.

Some success stories and connecting the dots with low serotonin

These two success stories illustrate how successful tryptophan and GABA can be and also how quickly they offer relief:

This blog post illustrates similar low serotonin symptoms and end-of-the-day timing in adults with Alzheimer’s – Sundowning in Alzheimer’s and dementia: melatonin/tryptophan for the agitation, restlessness, anxiety, disturbed sleep and aggression. It’s low serotonin that is the cause, regardless of the diagnosis.

This blog illustrates another mechanism for these types of disruptive behaviors: Christmas tree phenols as a trigger for anger, meltdowns, anxiety, hyperactivity, insomnia, aggression, self-injury and autistic symptoms? There is a serotonin connection when there are phenol issues too.

Resources if you are new to using amino acids as supplements

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), if you need serotonin support, the Serotonin QuickStart Program is a good place to start. This is a paid online/virtual group program where you get my guidance on using tryptophan and 5-HTP safely, and community support during 5 LIVE Q&A calls. You can sign up to be notified when the next live launch of this program is happening. We take a deep dive into product options including Lidtke products and others if you’re not able to access Lidtke.

If you also have low GABA symptoms, the next step to get help is the GABA QuickStart Program.This is also a paid online/virtual group program where you get my guidance and community support. Another option is the budget-friendly GABA QuickStart Homestudy program.

Now I’d like to hear from you

Have you been told your child may have Pathological Demand Avoidance (PDA)? Have you only been offered behavioral change tools and how have they helped?

Has low serotonin (and other biochemistry imbalances) been discussed too?

What symptoms does your child have and are things worse later in the day?

Has tryptophan helped reduce the above low serotonin symptoms in your child? How much helps and how quickly?

Or do you find 5-HTP works better? If yes, how much helps and how quickly?

What other biochemical changes have helped?

If you’re a practitioner, are you hearing about increased discussion of Pathological Demand Avoidance (PDA) and do you address low serotonin with your clients/patients?

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

Would using 5-HTP or tryptophan help when you crave sugar (as a sort of antidepressant) late afternoon/evening?

June 2, 2023 By Trudy Scott 29 Comments

Would using 5-HTP or tryptophan also help when you crave sugar (as a sort of antidepressant) late afternoon/evening? ~ Kimberley

This question was posed in response to my recent blog post about using tryptophan or 5-HTP to help with alcohol cravings/addiction in the late afternoon/evening – to help you wind down and relax, improve mood and sleep, and also as a reward/treat.

I said yes it is often the same cause when it happens late afternoon/evening and when there are other low serotonin symptoms like low mood, anxiety, worry, insomnia etc. When serotonin is low we self-medicate with wine, sugar, carbs, gluten, dairy and chocolate etc. in order to feel good, get a mood boost and reduce stress. 5-HTP or tryptophan stops the sugar cravings, acts as an antidepressant (improving mood) and eases other low serotonin symptoms too.

It turns out Kimberley was craving sugar late afternoon: “it’s definitely late afternoon for me, while I’m making dinner. Maybe it’s time to go back on 5-HTP.”

And then 2 days later she posted how quickly 5-HTP helped when she added it back mid-afternoon:

I was taking a break from tryptophan/5-HTP and realized after reading this post that that might be a mistake! So I added 5-HTP back in mid-afternoon and my sugar cravings are almost completely gone. It’s funny how I forget the symptoms of low neurotransmitters. Thanks for reminding me!

5-HTP works quickly when it’s low serotonin

How wonderful are these results for Kimberley. I never get tired of hearing feedback like this! I appreciate her sharing and giving me permission to share as a blog so you get to learn and be inspired too.

It’s not unusual for 5-HTP to work this quickly and when it does it’s a clue that the symptoms are related to low serotonin and that she found the ideal dose for her needs.

Kimberley had good results with 5-HTP in the past so she went back to what had worked for her before and it worked for her again.

But do keep in mind, some folks do better with 5-HTP and some do better with tryptophan so it’s a matter of doing a trial of each one each.

50 mg 5-HTP: the sadness and despair lifts in a few minutes

A week later she kindly came and shared additional details in the comments of the tryptophan/ 5-HTP alcohol cravings blog, saying:

It’s possible that I was already in the middle of my daily, mid-afternoon chocolate chip binge when I saw your post

I took a 50 mg 5-HTP along with my mid-afternoon Endorphigen capsule, and within just a few minutes I felt the sadness and despair that I often feel in the late afternoon, start to lift. I was astonished at how quickly it worked! I didn’t open the capsule, or chew it, I just swallowed it with water and had a snack afterwards. I really can’t thank you enough for asking that question because I was really struggling with low mood and sadness almost every day.

Even though KImberley had used 5-HTP with success in the past, she was still astonished how quickly it worked and how effective it was. She was also surprised she had forgotten her prior low serotonin symptoms:

Up until January I had taken 5-HTP in the mid-afternoon and then Tryptophan at bedtime, but I wanted to try a program to support my thyroid. That program told me that too much serotonin is often at the root of gut damage, so I weaned myself off of the 5-HTP and tryptophan. I didn’t really notice much difference, except the daily sugar cravings.

I’m not sure how I could so easily forget the symptoms of low serotonin, but I did.

Your question really was a God-send for me, Trudy. It reminded me that there was an option for feeling better (in fact, MUCH better than sugar makes me feel) that didn’t involve something that’s not good for me.

And I really did feel remarkably better the same day, and those results have continued.

Thanks again, Trudy, for continuing to bring these topics up. Some of us are forgetful and need reminding. Usually, when you have symptoms of low serotonin there are enough other issues going on in your life that it’s easy to overlook the obvious. So I’m very grateful that you asked the question, because I feel so much better able to deal with my circumstances now that I’m back on the 5-HTP. Blessings to you!

I am curious about the program that told her too much serotonin is often at the root of gut damage and if they suggested stopping 5-HTP and tryptophan. It doesn’t make any sense to me. I’ll report back when I learn more about this.

More tired during the day and a headache: what to consider

She did mention “I’m finding myself more tired during the day and have also had a headache for the last few days.” I would suspect chocolate/caffeine withdrawal may have caused her headache.

With feeling more tired I’d also watch the dose of 5-HTP. She may find less is better for her needs.

She is also trying tryptophan at bedtime so that may be making her more tired the next day. Doing one amino acid at a time is often the best way to know how each one is affecting you.

Finding what works for your unique needs

Here are some other amino acid/sugar cravings blog posts that illustrate how we all have unique needs and different biochemical imbalances:

The individual amino acids glutamine, GABA, tryptophan (or 5-HTP), DPA and tyrosine are powerful for eliminating sugar cravings, often within 5 minutes

The individual amino acids glutamine, GABA, tryptophan (or 5-HTP), DPA and tyrosine are powerful for eliminating sugar cravings, often within 5 minutes. It seems that this wonderful benefit – over and above the anxiety-reducing and mood-boosting benefits – is often overlooked or poorly understood.

GABA for ending sugar cravings (and anxiety and insomnia)

For Melissa, an unexpected result was that she stopped craving sugar (chocolates, ice cream and truffles) after about a week of taking GABA for her travel anxiety.

It’s a matter of finding what works for your sugar cravings and unique needs. GABA worked for Melissa and yet 5-HTP works for Kimberley – for their sugar cravings.

Here is the tryptophan/5-HTP alcohol cravings blog that started the discussion: Tryptophan had the added benefit of turning me completely off alcohol when I took it to improve mood and sleep during perimenopause. In this case, tryptophan helped Victoria quit the wine that she was self-medicating with in order to feel good and relax.

Resources if you are new to using amino acids as supplements

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 too). This is a paid online/virtual group program where you get my guidance and community support.

Has 5-HTP helped reduce your cravings and/or feelings of despair and sadness? How much helps and how quickly?

Or do you find tryptophan works better for you? If yes, how much helps and how quickly?

What sugary food/s do you self-medicate with in order to feel good?

If you’re a practitioner, do you use this approach with your clients/patients?

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