Children/Teens

Anxiety and vomit phobia in an 8-year-old: within a week of starting vitamin B6 she made a complete turnaround

December 1, 2023 By Trudy Scott 15 Comments

Debbie, a mom in the community, shared this wonderful feedback about how vitamin B6 helped her daughter with terrible anxiety and a phobia of vomit:

My youngest (who is 8 now) started exhibiting terrible anxiety about a year ago, specifically around the phobia of vomit. Her anxiety is mostly about other people throwing up. But her anxiety became so strong it was preventing her from going to school or even staying in her classroom, kept her from eating (because her anxiety hurt her tummy) and even from wanting to do extracurricular activities that she previously loved but now was afraid to attend in case a child might throw up there.

We started her on weekly therapy sessions, and I started her on GABA and tryptophan. While the amino acids helped a little, it wasn’t enough to calm the thoughts that plagued her all day at school and home. Most days I still couldn’t get her out of the car for school.

Through your website and some other research, I decided to try supplementing her with vitamin B6. Within a week of her starting B6 she made a complete turnaround. The anxiety would still come when a kid at school would say their tummy hurt, but she was able to calm herself down within minutes and talk through the worry.

We still have some low days (especially if we haven’t taken her supplements in a few days) but overall, she’s a new kid. Even the school asked what we are doing differently to get her to be calm again.

It’s wonderful to hear that within a week of starting vitamin B6 she made a complete turnaround.

This blog addresses some of the possible mechanisms (possible serotonin and GABA support, and addressing pyroluria), how much vitamin B6 she had her daughter use and optimal dosing, plus other factors like a good multi or B complex.

Some of the possible causes and mechanisms: serotonin and/or GABA support

According to the Child Mind Institute, “Emetophobia, or the severe fear of vomiting or seeing others vomit, is surprisingly common. Kids who already tend to be anxious are more likely to develop it. It leads to fear of things they associate with vomiting. Often it starts with avoiding places where they (or someone else) threw up, or places that remind them of it.”

They discuss therapy and medications as solutions whereas I am discussing nutritional solutions that address the root causes. In this case: addressing low vitamin B6 and its impact on serotonin and/or GABA.

This letter, Vitamin B6: A new approach to lowering anxiety, and depression?, published in 2022, mention a few studies concluding that vitamin B6 supplements “significantly reduce feelings of stress, anxiety, and depression.” It does this via an impact on serotonin and GABA production and this results in the calming of the nervous system.

This 2022 paper, High-dose Vitamin B6 supplementation reduces anxiety and strengthens visual surround suppression, also discusses a GABA mechanism: vitamin B6 supplementation “increases inhibitory GABAergic neural influences, which is consistent with its known role in the synthesis of GABA.” (100 mg/day of vitamin B6 was used by the adult participants)

In this blog post you can read about the role of low vitamin B6 and iron in low serotonin, leading to anxiety and panic attacks.

How much vitamin B6 to use and is pyroluria a factor?

Debbie was not sure how much vitamin B6 to give her daughter:

The struggle I still have is knowing how much to dose her. There’s conflicting info out there as to how much is too much for kids. Right now I’m giving her Carlson liquid B6. I give her between 2-3 drops, which, if I’m doing the math correctly, is about 4-6 mg. She seems to be doing alright on that as long as we don’t miss a day. When we do miss, her anxiety becomes immediately irrational again. If you have any insight on dosing, please let me know. Thanks for all you do!

I shared this feedback with her: With phobia of vomiting I immediately think of the social anxiety condition pyroluria and the additional need for zinc, vitamin B6 and evening primrose oil.

This supports the fact that vitamin B6 helps her daughter and that missed days and increased stress means the anxiety returns.

With kids anxiety can often show up as tummy issues and nausea. And “emetophobics are particularly vulnerable to somatic symptoms, especially gastrointestinal symptoms such as nausea. Nausea, as an anxiety symptom, may be misinterpreted as an imminent episode of vomiting causing further symptoms in a vicious circle.” (from this paper about an 8 year old boy with emetophobia)

Debbie mentions her daughter gets a sore tummy when anxious. If she also feels nauseous on her bad days, that would be another clue to consider pyroluria. A common symptom is morning nausea and addressing pyroluria helps kids who experience this and also helps prevent vomiting. The nutrients for pyroluria are also key for neurotransmitter production (as mentioned above).

I shared that I’ve used 10 – 25mg of vitamin B6 in children this age who have pyroluria (plus the other pyroluria supplements and stress reduction).

Good dream recall with no nightmares is a good gauge of vitamin B6 status and a clue that enough is being used and easy enough to ask children and/or observe nightmares.

There are not many papers on the use of vitamin B6 in children. This study, Use of Nutritional Supplements Based on L-Theanine and Vitamin B6 in Children with Tourette Syndrome, with Anxiety Disorders: A Pilot Study used 2.8mg of vitamin B6 but they were also using theanine.

Supportive solutions: a child’s multi with B vitamins and other underlying factors

When an individual B vitamin like vitamin B6 is used, it’s always advised to use a B complex or a good multivitamin that contains all the B vitamins with sufficient amounts. For children I like a product like Klaire Labs Vitaspectrum ® Powder. This product may actually provide enough vitamin B6 in a situation like this – 1 scoop provides 15 mg of vitamin B6 – or it could be used with extra vitamin B6.

It goes without saying that all dietary and other nutritional factors, gut health, blood sugar handling, sleep, toxins, infections etc. may need to be addressed too.

I would also want to do further exploration into why vitamin B6 may be low, other than pyroluria – such as dysbiosis, inflammation, malabsorption, autoimmunity, low dietary intake, leaky gut, high sugar intake, gluten sensitivity or celiac disease and alcohol use disorder (in adults).

Why didn’t GABA or tryptophan help?

Debbie is well versed in amino acids, having used GABA for her PCOS (polycystic ovarian syndrome). It helped ease her lifelong anxiety, wean off anxiety medication, ovulate each month and stop her PCOS meds. She helped her older daughter with GABA too – she calls them her “happy pills.” And Debbie used tryptophan with success when collagen caused her to have panic attacks again. You can read her story on this blog.

I can’t be sure why GABA or tryptophan didn’t help her younger daughter. It’s where I would have started too, but we are all unique and what works for Debbie and her older daughter just didn’t work for her younger daughter.

It’s possible that a higher dose of GABA or tryptophan may have worked better, or other GABA or tryptophan products, or theanine or 5-HTP or inositol may have been an option.

It’s wonderful that vitamin B6 did work and I appreciate Debbie for sharing and allowing me to share as a blog. I love that the school also asked what they are doing differently to get her daughter to be calm again.

Additional resources when you are new to using amino acids or the pyroluria nutrients as supplements

We use the symptoms questionnaire to figure out if low GABA or low serotonin or low endorphins or low dopamine or low blood sugar may be an issue with vomit phobia.

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.

As mentioned above, I would start with GABA and tryptophan (like Debbie did) and then start looking for other approaches that may help.

There is also an entire chapter on pyroluria where vitamin B6, zinc and evening primrose oil is addressed in detail.

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.

This includes the products mentioned in this blog: Carlson 100mg B6 and Klaire Labs Vitaspectrum® Powder.

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.

Does any of this resonate with you?

If yes, has vitamin B6 helped your child (or you) with anxiety and vomit phobia?

And is pyroluria also a factor that is being addressed?

Have either tryptophan or GABA or Klaire Labs Vitaspectrum® Powder helped too (alone or in conjunction with vitamin B6)?

Feel free to share and ask your questions below.

My 12 year old son has ADHD, is impulsive, is a loner, craves carbs, and doesn’t do well or care about school – should he be on GABA?

July 21, 2023 By Trudy Scott 17 Comments

I’ve been reading your blogs and I’m trying to decide if my 12 year old son should be on GABA? He has ADHD, is impulsive, is a loner, craves carbs, and doesn’t do well or care about school.

Can you tell me what supplement he could be deficient and where to purchase? He is currently on ADHD medication (Focalin) during the school year.

Janice asked the above question about her 12 year old son. I wish it was as simple as just using the calming amino acid GABA but it’s seldom one amino acid that is the answer. GABA is often one of many supplements that may help and in this instance I suspect a combination of neurotransmitter imbalances (low GABA, low dopamine and low serotonin), pyroluria, other possible nutritional deficiencies and dietary factors are at play. Read on to hear my approach for working through what may help this young man improve his focus, reduce his carbs, actually care about school and doing well, reduce his impulsivity and help him fit in socially – and ultimately lead to him being a happier, calmer and healthier child.

GABA with preteens who have ADHD and spinning-type symptoms

I always start with one of the amino acids because we get quick results and immediate feedback. Since Janice asked about GABA, this is the GABA feedback I shared with her: I’ve had good results with GABA with preteens who have ADHD and spinning-type symptoms. One clue is when the craving of carbs is driven by stress i.e. stress eating. I always start with the symptoms questionnaire and have the parent rate each low GABA symptom on a scale of 1-10, with 10 being most severe, ideally in conjunction with their child.

I then have the child do a one-off trial of GABA and we observe improvements in the next 5-30 minutes. If the child reports any improvement in any of the symptoms – in this case focus and spinning driven by anxiety – the child continues with GABA and increases over the next few weeks to find the ideal dose for their needs.

Sometimes focus issues are so severe that it’s too challenging to rate symptoms before, doing a one-off trial of GABA and then rating symptoms afterwards. In cases like this, mom makes the decision to have their child use GABA before school, when they get home and possibly early evening too. Mom can observe their focus and spinning: like getting dressed and ready for school, settling down to homework in the afternoon and settling down for bed.

Relying on feedback from school is invaluable too. Stress related carb cravings are also assessed i.e. does he seek out sugar when stressed and anxious.

A mom shares how GABA helps her 11 year old daughter – GABA for children: ADHD, focus issues, irritability, anxiety and tantrums

My daughter hasn’t been diagnosed with ADHD but has a lot of ADHD qualities. We were having a huge amount of behavior problems as she is getting older (she’s 11). She has had amazing behavior at school and at home since giving it to her. She’s almost like a different child. GABA has truly changed our life.

…before the GABA she was irritable, she was fighting with her teacher and schoolmates, she couldn’t focus and was distracted by anything and everything, she was constantly disrupting the class and she was throwing major tantrums over ridiculous stuff (like her hair didn’t do what she wanted), she was mouthy and everything was a fight.

We are not seeing 99% of those behaviors at all anymore. She of course is still your typical pre-teen but if I say “no you can’t have that” our “no you can’t go there” her reaction is OK. Before it would have been a major fight or meltdown. Her teacher is reporting to me every day about her wonderful days.

Tyrosine for focus issues, low motivation and low energy type carb cravings

With focus issues I would also consider the role of low dopamine and do a trial of tyrosine. Other clues: are his carb cravings related to low energy and is there also low motivation tied to the fact that he doesn’t care about school? Are there also signs of depression or low mood?

We go back to the symptoms questionnaire and have the parent rate each low dopamine/low catecholamine symptom on a scale of 1-10, with 10 being most severe. Again, do this in conjunction with the child if possible.

We only do a trial of one amino acid at a time so we know what is working. Assuming the GABA has been helping, we’d do a trial of tyrosine next and look for improvements in focus, carb cravings (all neurotransmitter imbalances can lead to carb cravings), motivation and mood.

If the one-off trial approach is not an option, tyrosine is also used before school and right after school but no later than 3pm so as not to affect sleep. Again, the above symptoms are tracked.

In this blog both GABA and tyrosine help this teen: GABA helps 14-year-old with Tourette’s Syndrome (the tics and sleep), and tyrosine makes him happier and his mind sharper

Tryptophan or 5-HTP for ADHD/hyperactivity and afternoon cravings

Hyperactivity can also show up with low serotonin, and so can something like not caring about school i.e. a low mood. A clue here is when his carb cravings are more intense – with low serotonin it’s typically afternoon or evening.

We go back to the symptoms questionnaire and have the parent rate each low serotonin symptom on a scale of 1-10, with 10 being most severe. And again, it’s best to do this in conjunction with the child if possible and do a one-off trial of tryptophan or 5-HTP.

If that’s not possible, tryptophan or 5-HTP is used mid-afternoon and evening and symptoms are tracked. This can be layered in on top of the GABA and tyrosine if they are offering some relief.

Here is a blog post where a mom shares how 5-HTP helps her child – ADHD: 5-HTP melts have been a miracle for one of my adopted kids

5-HTP melts have been a miracle for one of my adopted kids. He had lots of trauma and off the charts ADHD. 5-HTP is better than methylphenidate (Ritalin) and we are now weaning off the non-stimulants.

Just 80 mg 5-HTP in the morning is all he needs. He was super ADHD, he had a para (teacher’s aide) in public school for years to keep him on track and this year at a school for ADHD the teachers were complaining that he was never on task. Now after a week it has changed his life.

Addressing pyroluria, low lithium, low zinc, low blood sugar and diet

Janice mentions her son is a loner so we’d look into pyroluria/social anxiety and add zinc, vitamin B6 and evening primrose oil (and other key nutrients). Keep in mind that zinc deficiency is common and is often low with ADHD.

She also mentions that he is impulsive. Impulsivity and ADHD is common with low levels of lithium. A big clue is a child having a roller-coaster of emotions. I use this low lithium questionnaire to assess for a need for low dose lithium (a nutritional supplement).

I consider low blood sugar with all my clients and with this young man low blood sugar may be contributing to his focus issues, low mood and desire for carbs. The amino acid glutamine helps as does breakfast and meals with quality animal protein and healthy fats.

And it goes without saying that dietary factors must always be addressed. My book is a great resource when are looking for a comprehensive dietary approach, which is needed with ADHD and the symptoms Janice describes – The Antianxiety Food Solution. There is also a chapter on low blood sugar, pyroluria and the amino acids.

If you are an adult and can relate to any of these symptoms and feelings, the same process applies. Just remember this: there is no one-size fits all since we all have unique biochemistry.

Side effects and longer term effects of stimulant medications

I appreciate Janice for reaching out and asking this question. Hopefully, implementing some or all of these changes, will allow her son to stop his stimulant medication, Focalin. This medication is similar to Ritalin (methylphenidate), which can cause the following side-effects: feeling sad or empty, irritability, loss of interest or pleasure, trouble concentrating, trouble sleeping (and many more).

These stimulant medications can also play a role in longer term health effects that include heart disease and the possibility of it being a gateway drug to other stimulants. The research on the latter is hotly debated but it is often seen clinically.

Resources if you are new to using amino acids as supplements

To recap, 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, low dopamine, low blood sugar and low endorphins).

As mentioned, 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.

Have any of the above amino acids helped your child or you with the following symptoms: ADHD and poor focus, carb cravings and low mood/low motivation (doesn’t care)?

Has the pyroluria protocol helped your child or you be less of a loner?

Has low dose lithium helped your child or you with impulsivity and focus issues?

Have dietary changes helped too?

If you are a practitioner, are you using amino acids, the pyroluria protocol, low dose lithium and dietary changes with success in cases like this?

Feel free to post your questions and feedback 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

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).

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.

My 6 year old was having panic attacks getting out of the car for Kindergarten: GABA has completely relieved him of his fears

January 27, 2023 By Trudy Scott 12 Comments

My 6 year old son was having panic attacks getting out of the car going to Kindergarten and taking two GABA Calm has completely relieved him of his fears. He has been going for 3 straight weeks in a row.

I thought it may be low serotonin since this happened last winter as well but I gave him 5-HTP for a couple months and it didn’t seem to affect him and his anxiety. We had to have him repeat Kinder this year.

But wow, the GABA has been fabulous and Kindergarten is in full swing because of your help.

This is from Lisa, a mom in the community. I never get tired of getting feedback like this – how wonderful for this young boy and his family. She shared this very positive outcome on one of the GABA blogs, asking this question (which I address below):

Quick question…does the GABA have to be taken on an empty stomach to work? We try to give it as soon as he is awake and wait to eat for 15-20 mins but sometimes it’s not possible.

The timing of GABA and tracking symptoms

I share that GABA is best taken on an empty stomach and ideally 30 minutes away from protein-containing food. But I also say that the way she is having him use it is clearly working for him. In a situation like this it’s simple enough to track the outcome on days they do wait 15-20 mins and on days when it’s not possible to wait the 15-20 mins (and make a note of how close to food he does take GABA). How is his anxiety, fears and panic attacks in these two situations?

Lisa shared that GABA works well in both instances:

We will keep doing the no food for 15-20 minutes after taking it because it is obviously working. We’ve only had it happen where he eats after about 5 mins and it seems to still do the job.

This sounds like a great plan. If they can, I would also do a trial waiting the full 30 minutes and see how he does on those days. She may find with the longer duration he only needs one GABA Calm.

It may also be that because GABA is being used in a sublingual manner like this, it can be used closer to food. Perhaps a trial right after food is worthwhile. I’m sure it will reduce some of the early morning stress and rush getting ready for Kindergarten.

I also confirmed with her that he is using the Source Naturals GABA Calm product. This is the sublingual product (with just 125mg of GABA and a few other ingredients) that I have so much success with. You can read more about it here – Source Naturals GABA Calm™: Why I recommend it for anxiety.

The school is in shock at how well carpooling is going for him

I love that the school is now in shock and that this mom went with her instinct and pulled him out of school the first year his fears showed up:

We just got a call from the school today and they are in shock at how well carpooling is going for him. They wanted to know what I was doing, ha! He had been a star student so they were shocked when he started to have meltdowns and panic attacks, running away and into traffic about 3 months into school. We deal with a bit of ADHD at home (it’s manageable with the diet) but anxiety is what most see on the outside.

We are repeating Kindergarten because half way through last year he started to panic getting out of the car. The previous school wanted to grab him out of the car and have me drive off. They said he would calm down better without me. What? Just what I want to do is traumatize my child at the start of his academic life. I pulled him and we waited since he was on the younger side and put him in a fabulous charter school this year.

The GABA has taken all those fears out and has been a huge bridge for him to get to school.

I do hope Lisa told the school exactly what he’s doing with GABA and how quickly it’s helped him. So many children are struggling with anxiety and mental health issues and could do with nutritional support like GABA and some of the dietary changes he had made before using GABA (more on that below).

5-HTP didn’t help and why a switch to tryptophan may have helped

You’ll notice she mentioned that 5-HTP had not helped the previous year:

I thought it may be low serotonin since this happened last winter as well but I gave him 5-HTP for a couple months and it didn’t seem to affect him and his anxiety.

Fear and panic attacks are common with low serotonin so it’s good that she did a trial of 5-HTP. Here are some of my insights:

I would not have someone use 5-HTP for a couple of months – the amino acids work quickly so a week or possibly two should be enough to decide whether to continue or stop
You always want to increase until you find the ideal dose. I’m not sure how Lisa approached this aspect.
When there are low serotonin symptoms and 5-HTP doesn’t work, we switch to tryptophan. 5-HTP works well for some and tryptophan works better for others. You can see all the low serotonin symptoms here

It’s possible her son may still benefit from additional serotonin support. Or it may be that the GABA is all he needs. With ADHD it may be worth investigating tyrosine too.

Dietary changes: gluten, dairy, phenols and high histamine foods

It’s important to always address the foundational diet so I checked with Lisa about dietary changes. This is key to not needing long-term GABA supplementation (once other causes of low GABA are addressed – such as Lyme disease, phthalates, aspartame, gut health etc). She shared this about his diet:

He has always been gluten free and dairy free (only goats milk as a baby). We follow the Feingold Diet and try to stay away from high histamine foods as it causes his anger and anxiety to be worse.

It’s great she has made these foundational dietary changes with gluten and dairy – both can exacerbate mood issues. The Feingold diet eliminates phenols. Both phenols and high histamine foods can be problematic for many children too, as she reports.

All these dietary factors are so key but even then additional neurotransmitter support is often needed and in this instance it’s GABA that he clearly needs. Because of his issue with histamines it’s possible he may not have tolerated pharmaGABA (a fermented GABA) so GABA Calm was a good first choice for the initial trial.

Pyroluria testing – why I often don’t use this urine test

I know he has some imbalances so we need to do an OAT test and pyroluria test (I have pyroluria so I know he is bound to have it). Money is the issue at the moment so the GABA chewables have been a true lifesaver. I can’t thank you enough!

I let her know that I don’t often have clients do the urine test for pyroluria because of the false negatives. He’s doing really well but children with pyroluria are really good at masking and pushing through (and so are adults, as I’m sure Lisa already knows). The pyroluria protocol (zinc, vitamin B6 and evening primrose oil) provide raw materials for neurotransmitter production and can help with ADHD symptoms too. We simply do a trial of the protocol when symptoms exist and determine if they are helping.

I love her comment: “the GABA chewables have been a true lifesaver.” This and the outcome for this 6 year old is the reason I love the amino acids. They offer incredible results and relief from anxiety, fears and panic attacks, while you are working through testing (like the OAT and others) and other contributing root causes.

I said her feedback is really inspiring and I’d love to share it as a blog post for other families. She kindly responded with this:

You can definitely write up a blog post about it. If I can help other families going through the same thing it was all worth it. If you have any other questions don’t hesitate to ask. Thank you again for sharing all your knowledge.

I appreciate her willingness to post their success and her permission to share as a blog post.

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

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

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

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.

Have one of your children experienced similar results with GABA offering relief for anxiety, fears and panic attacks? Which GABA product helped your child and how much helped?

When using sublingual or chewable GABA products like GABA Calm, have you found the timing in relation to foods being important?

What dietary changes has your child also made and how have they helped?

If you have questions and feedback please share them here too.

Alice in Wonderland Syndrome – is there a pyroluria connection?

June 25, 2021 By Trudy Scott 48 Comments

I first learned about Alice in Wonderland Syndrome (AIWS) during one of the Anxiety Summits. I’m surprised at how many queries I get about this syndrome and the fact that everyone who has reached out also has the social anxiety condition called pyroluria or suspects they have it.

This 2017 paper, Alice in Wonderland Syndrome: A real life version of Lewis Carroll’s novel, describes it as follows:

Alice in Wonderland Syndrome was originally coined by Dr. John Todd in 1955. The syndrome is named after the sensations experienced by the character Alice in Lewis Carroll’s novel Alice’s Adventures in Wonderland. Alice in Wonderland Syndrome consists of metamorphopsia (seeing something in a distorted fashion), bizarre distortions of their body image, and bizarre perceptual distortions of form, size, movement or color. Additionally, patients with Alice in Wonderland Syndrome can experience auditory hallucinations and changes in their perception of time. Currently, there is no known specific cause of Alice in Wonderland Syndrome. However, theories point to infections such as the Epstein-Barr virus, medications such as topiramate and associated migraines.

You can read about all the types of visual and non-visual distortions in this paper: Alice in Wonderland syndrome – A systematic review. This paper also includes a list of conditions in which Alice in Wonderland syndrome has been described in the literature, with infections and migraines being very common. The authors also feel that what we see in the published literature may only be the tip of the iceberg:

Since 1955, no more than 169 case descriptions of AIWS have been published. The literature indicates that this may be only the tip of the iceberg, with many individual symptoms of AIWS being experienced (albeit occasionally and only fleetingly) by up to 30% of adolescents in the general population.

The published case numbers have increased slightly (this paper was published in 2016) and it’s reported that many of the 30% of adolescents with AIWS experience non-clinical symptoms i.e. they are not severe enough to need treatment.

I still find “up to 30% of adolescents in the general population” to be very surprising for a syndrome which was once considered very rare and is frequently misdiagnosed.

Read on to hear from some folks in my community who have reached out and described their AIWS episodes. They all have pyroluria and I’d love to know if there is a possible connection.

Everything either looks really far away but massive or really close up but tiny

Sallie, a mom in my community, shared about her son and what he experienced in the comments section of the pyroluria prevalence and associated conditions blog. During his episodes, everything either looks really far away but massive or really close up but tiny:

I believe he has Alice in Wonderland syndrome. I have taken him to GP’s, pediatricians, optometrists, opthamologists and no one knew what was wrong. I spent about 6 months researching the possibilities myself and came across AIWS. When I showed him some of the journal articles, he was so relieved to finally have an answer. Since then, I have had a gut feeling that pyroluria and AIWS may be linked somehow.

She believes his AIWS may have been triggered by an infection when he was around 6 years of age. He developed sudden onset of vomiting, fever and delirium:

Still to this day, he distinctly remembers this night and recalls (like it was yesterday) not being able to stop looking at his hands because they were changing size and how far away/close up they were.

Once he was old enough to articulate what he was experiencing, he was able to tell me he feels weird, like he needs to go to a pitch-black room and lie down. Sometimes it coincides with a headache.

Everything suddenly appears as if far away then everything either looks really far away but massive or really close up but tiny. He feels dizzy while this happens also. Stress definitely increases the number of AIWS episodes.

Infections are reported as one (of possibly many) root causes of AIWS: “Reported causes include infection (especially with Epstein Barr virus), migraine, epilepsy, depression, and toxic and febrile delirium.”

Infections are common mental health triggers. Strep as a trigger for PANDAS/PANS is a classic example. I blog about Bartonella and sudden-onset adolescent schizophrenia here.

He has pyroluria and stress increases the number of episodes he experiences. My question is this: is there a link between the dumping of zinc and vitamin B6 during these times of stress and episodes of AIWS?

The feeling of being extremely small somatically (or physically), like how you feel when in a football stadium

Mike is a 21 year old male and thinks he may very well have pyroluria based on the questions. He also shares this in the blog comments about his AIWS experiences:

I have experienced sensations similar to Alice in Wonderland Syndrome throughout my life, more so during periods of stress. The feeling of being extremely small somatically (or physically), like how you feel when in a football stadium.

Again, he has pyroluria and his symptoms are worse during periods of stress. Keep in mind that stress makes pyroluria symptoms more intense too.

She usually experiences objects/people smaller than what they are but her more pronounced symptoms are sound distortions

Brenda, another mom in the community, shared this about her daughter’s dreams and PMS on the pyroluria questionnaire blog:

I’m quite certain that my 17 year old daughter has pyroluria. I counted 23 symptoms that she definitely exhibits. Her dream recall is so poor that she insists she doesn’t dream at all. I’m going to start her on zinc, B6 and evening primrose oil right away. Her PMS/premenstrual syndrome is so severe that I had decided to see a gyno to discuss birth control pills. Of course I won’t after listening to your interview with Karla Maree (on the Anxiety Summit).

She also asked if I was familiar with Alice in Wonderland Syndrome and if so do I think it may be connected to pyroluria? She shares this about her daughter’s AIWS experiences:

My daughter has experienced occasional Lilliputian (trivial or small) hallucinations since childhood. She usually experiences objects/people smaller than what they are but her more pronounced symptoms are sound distortions. She hears voices/noises (real, not imagined) much louder than they are in reality.

She does not have migraines, has never had mononucleosis or any of the other conditions listed as possible causes of Alice in Wonderland Syndrome. That’s why I’m thinking it may be caused by nutritional deficiencies.

This was my introduction to this syndrome and I appreciate her for asking the question. I did some reading of the research and the word “hallucination” got me thinking that a pyroluria connection was possible. The original work by Dr. Carl Pfeiffer with pyroluria was with individuals with schizophrenia.

However, the second paper mentioned above does state that “AIWS is characterized by perceptual distortions rather than hallucinations or illusions and therefore needs to be distinguished from schizophrenia spectrum and other psychotic disorders.”

We clearly have much to learn and I’m still curious to find out how often these two conditions do overlap – pyroluria/social anxiety and Alice in Wonderland Syndrome.

Resources if you are new to pyroluria

Pyroluria is a social anxiety condition and the physical and emotional symptoms are caused by deficiencies of vitamin B₆ and zinc. When you experience high levels of stress, vitamin B₆ and zinc will be further depleted, so you may notice worsening symptoms and more anxiety. Here is the symptoms questionnaire and additional resources if you are new to pyroluria:

Pyroluria questionnaire (from my book, The Antianxiety Food Solution):
Pyroluria prevalence and associated conditions
Social anxiety caused by pyroluria: oxytocin, the vagus nerve, pectus excavatum and Ehlers-Danlos Syndrome
My book, The Antianxiety Food Solution, has an entire chapter on pyroluria

Have you (or a family member) had episodes of Alice in Wonderland Syndrome? And do episodes coincide with times of added stress?

Do you also suspect pyroluria and has the pyroluria protocol or other nutritional interventions helped to reduce or stop the episodes?

I’d love to also hear anything else you’re willing to share: age at onset, age AIWS stopped, do you suspect an infection as the trigger (or a medication or toxins or something else?), do others in the family have AIWS episodes and how would you describe your AIWS episodes?

Feel free to post any questions here too.

Rage, anxiety, cravings & insomnia in 11-year old girl with RAD/reactive attachment disorder: chewable tryptophan turns things around

May 28, 2021 By Trudy Scott 21 Comments

Today I’m sharing the case of an 11-year-old girl who had huge rage issues, was angry much of the time, suffered from terrible anxiety, had crazy sugar cravings (for bread and colored candies) and had dreadful insomnia. Because of the insomnia she was also very fatigued and this likely drove some of her cravings and irritability too. She was adopted and had been diagnosed with RAD (reactive attachment disorder). During our first session, chewable tryptophan turns things around quickly – she smiles and is willing to make changes and quit the sugar and gluten. We also address low iron levels and with these 4 nutritional interventions this child’s behavior improves dramatically.

This book chapter, Reactive Attachment Disorder, states how The Diagnostic and Statistical Manual 5th Edition (DSM-5) classifies reactive attachment disorder as follows:

a trauma- and stressor-related condition of early childhood caused by social neglect or maltreatment. Affected children have difficulty forming emotional attachments to others, show a decreased ability to experience positive emotion, cannot seek or accept physical or emotional closeness, and may react violently when held, cuddled, or comforted. Behaviorally, affected children are unpredictable, difficult to console, and difficult to discipline. Moods fluctuate erratically, and children may seem to live in a “flight, fight, or freeze” mode. Most have a strong desire to control their environment and make their own decisions. Spontaneous changes in the child’s routine, attempts to discipline the child, or even unsolicited invitations of comfort may elicit rage, violence, or self-injurious behavior.

Reactive attachment disorder/RAD and low serotonin

There is no research on tryptophan helping to address RAD symptoms or trauma, but based on her low serotonin symptoms, a trial of tryptophan was the first thing I considered.

There is, however, evidence to indicate the role of low serotonin in RAD, as indicated by a study where antidepressants were successfully used. The authors mention how:

The absence of responsive and consistent caretaking can subject the developing brain to an inordinate amount of physiological stress, leading to increased cortisol production and consequential inefficiencies in the serotonin and the growth-hormone releasing systems.

Although not specific to RAD, another paper looking at trauma states that:

Serotonin and dopamine levels were found to be abnormal in the presence of PTSD.

As the field of nutritional psychiatry grows, I expect to see more and more research supporting the use of tryptophan and other amino acids for those suffering from symptoms like this. Symptoms that are caused by imbalances that are triggered by the trauma in their lives.

We know that therapy, EFT, EMDR and other approaches are crucial for trauma recovery (this family had already done some of this work) but we must start to incorporate nutritional support too.

The case study

Here are the details of this case study and the nutritional interventions. As I mentioned above, because of her severe rage episodes, a trial of tryptophan was the first thing I considered:

She was referred to me by a friend. The family didn’t have much money. And so, we had to really try and figure out a few simple interventions that we could use that were going to be effective.

This young girl had been adopted. She was diagnosed with reactive attachment disorder and her anger issues were just phenomenal. The mom had to physically put her body around her and hold her down when she was having one of her fits because she was worried that she was going to hurt herself and hurt other people.

She also had anxiety, huge cravings for colored candies and insomnia. She was so fatigued because she wasn’t sleeping well.

So sitting in my office with this young girl and her mom, we started to talk about the sweets and the candies and the need to give up the candies. She was fuming with me. She was sitting in a swivel chair. She turned her back on me and didn’t want to talk about having to give up candy at all.

I said, “Look, let’s not even talk about that, but would you take this chewable tryptophan here? And we’ll talk about it in a second.” I gave her 100 mg of the chewable tryptophan and continued discussing things with her mom. She had no idea what it was going to do or how it would make her feel.

Within five minutes she turned her chair back, looked at me and she said, smilingly, “Yes, let’s do it. I can give up the candy.” She was smiling and she was happy.

So long story short, with this young girl, we started her on [chewable] tryptophan [and it turned things around quickly].

Chewable tryptophan – when I use it and when I don’t

I typically use 500mg Lidtke tryptophan for the adult clients I work with and prefer this company’s product because it is really high quality. It really does work better than many other tryptophan products on the market.

Lidtke also makes a chewable 100mg tryptophan which is also high quality, and the product I used with this young girl. Here are some benefits of this 100mg product:

It’s useful for doing the initial trial in order to figure out if tryptophan is going to help with low serotonin symptoms in children – because it’s a lower dose.
It’s especially useful for children for ongoing use (typically midafternoon and evening) because it’s a lower dose.
It’s also useful for adults who are “pixie dust” folks and do better with a lower dose of supplements in general or respond more severely to medications/alcohol/chemicals. We may start with a trial of the 100mg chewable and increase from there, also typically midafternoon and evening.

I don’t use the chewable 100mg tryptophan under these circumstances:

When the child (or adult) finds that 5 x100mg works for them at each time they need it. In this instance it’s best to switch to a 500mg tryptophan. Using it swallowed may work or it may need to be opened onto the tongue.
When the child (or adult) starts to consume the chewables like candy. They are sweet and do taste good and I’ve seen this happen. Because you are continually consuming something sweet you may end up over-consuming them if sugar addiction is one of your issues. You may also end up taking too much tryptophan.

If the chewable tryptophan is not available where you live, using a small amount of a powdered tryptophan or opening a capsule of the 500mg tryptophan is an option. Since it tastes bitter it can be mixed with mashed banana or inositol. (You can find all the Lidtke products in my online supplement store. The link is in the resources section below.)

Gluten and candies were also a huge issue, and she had low iron

There was more to her issues than only low serotonin:

Gluten was also a huge issue, so we got her off gluten and the candies. The tryptophan helped with this” (i.e. it made it easy to break the addiction and not feel deprived).

Tryptophan also helped her sleep. And it helped with the severe rage issues.

Obviously the gluten was contributing to the rage issues as well.

Her iron and ferritin levels were really low (possibly as a result of her gluten issues). So we added an iron supplement, and animal protein/red meat.

So with just four interventions – the gluten, the animal protein, getting her iron levels up and the tryptophan – this kid was just a new kid.

Here are some articles that are related to the above:

The role of low serotonin, low vitamin B6 and low iron in anxiety and panic attacks
Integrative Medicine Approach to Pediatric Obsessive-Compulsive Disorder and Anxiety I write about a study where gluten was found to be the cause of a childhood case of obsessive-compulsive disorder (OCD)
Tryptophan for my teenager: she laughs and smiles, her OCD and anxiety has lessened, and she is more goal oriented and focused on school.

Keep in mind there is not a one-size-fits-all and these 4 simple nutritional interventions – tryptophan, gluten removal, adding red meat and addressing low iron – happened to be the combination that worked for this young girl.

Resources if you are new to using tryptophan as a supplement

If you are new to using the amino acid tryptophan as a supplement, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

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

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 Lidtke chewable tryptophan 100mg, Lidtke tryptophan 500mg and other products that I use with my individual clients and those in my group programs.

We use an amino acid like tryptophan for quick relief of symptoms, like I did in this instance. Then we focus on the foundations like diet – like no gluten and red meat in this instance – and address all other imbalances, like her low iron. If cortisol was high we would have addressed that.

This case deserves it’s own blog post

In case you’re wondering, I first shared this case study in my interview, “Calming Anxiety, Aggression and OCD with Amino Acids and Food”, on the ADHD and Autism Summit in May 2021. Due to the interest in this case and the use of chewable tryptophan, I felt it deserved a deeper dive and its own blog post with links to some of the research and some practical information about the chewable tryptophan.

Have you used this chewable tryptophan product with success – personally, with your child or with a patient/client?

Have you found that addressing serotonin with tryptophan (or 5-HTP) helps resolve symptoms in a child diagnosed with RAD or a child with rage issues? What about helping with sleep problems, easing anxiety and stopping cravings too?

Have you addressed low iron levels and seen improvements with the removal of gluten too.

Feel free to post your questions here too.