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GABA

Anxiety and globus pharyngeus (lump in the throat): GABA to the rescue?

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globus pharyngeus and gaba

Low levels of GABA, a calming neurotransmitter can lead to anxiety, fears and panic attacks. With low GABA, the anxiety is a physical kind of anxiety with muscle tension or muscle spasms.  Today you’ll read how low GABA may be one possible root cause of globus pharyngeus, which you may have experienced as a rather scary golf-ball-like lump or constriction in the throat.

Let me describe globus pharyngeus and then I’ll share my story with globus pharyngeus, why low GABA may be a factor (and supplemental sublingual GABA to the rescue) and other possible root causes that should be considered.

This 2015 paper, Globus pharyngeus: an update for general practice, defines it as follows:

Globus pharyngeus or globus sensation is the painless sensation of a lump in the throat and may be described as a foreign body sensation, a tightening or choking feeling.

Globus means globe or sphere and it can actually feel like you have a golf-ball sized object in your throat.

You may have experienced it without even knowing the medical name. Only a few of my clients and those in my community have ever heard the term. I also only learned about the name many years after my episode.

What is very surprising is that, according to the above paper, up to 45% of the population have experienced it.

My story with globus pharyngeus

I’m one of the 45% and for me it was a terrifying experience.  As you may know, I experienced anxiety, PMS, fears and panic attacks in my late 30s and early 40s (it’s why I do this work).

Fortunately I only had one episode. It truly felt like I had a golf-ball in my throat and was horrifying. I knew I needed to swallow so I could get rid of this obstruction but at the same time I was terrified to swallow in case it got stuck and choked and killed me.

I remember going to the mirror to try and see this golf-ball sized object in my throat. I was so surprised that I couldn’t see anything.

Looking back, I suspect the addition of GABA Calm to my protocol prevented further episodes. I was also using progesterone cream at the time and this promotes GABA production too.

I’ve had many clients report that looking back they also realized their episodes stopped once they addressed their low GABA levels.

I was also under a great deal of stress at the time: work stress (long hours and my adrenals were a mess) and physical stress (due to amalgam removal, gluten issues, perimenopausal changes and much more).

Globus pharyngeus and GABA

The fact that the throat or pharynx “is a muscular tube that runs from the back of your nose down into your neck” is one reason for considering a muscle spasm and low GABA as a root cause.

The amino acid GABA, when used sublingually, eases muscle spasms within 15 seconds to 2 minutes. Some examples where we see this:

If you’re in the midst of an episode it’s impossible to open a capsule of GABA into your mouth. Until a client knows how much they can tolerate we start with 100-125 mg and increased based on the trial.  Taking the powder and dabbing it with a wet finger and putting the finger to the inside cheek a few times is the best way for quick relief.

A product that is GABA-only in a capsule such as Enzymatic Therapy GABA or ProThera 500mg GABA are my choices for in-the moment relief (more on these in my supplement store here).

Source Naturals GABA Calm is my most popular GABA product and is my choice for everyday use.

Of course, I recommend this approach to doing nothing. The authors state: “simple reassurance may be all that is required” or “Advise patients to resist the urge to dry swallow.” We can do better.

Once your GABA levels are sufficient, it’s less likely to happen unless you’re under a great deal of stress and/or there are psychological factors at play:

There is increased reporting of stressful life events prior to development of symptoms and research suggests that as many as 96% of patients with globus sensation report an exacerbation of symptoms during times of emotional intensity.

During times of added stress, folks may experience other “physical symptoms such as palpitations, poor sleep, and feelings of panic.”

Other root causes and possible solutions

The above paper does also list other root causes and solutions that would need to be investigated if GABA doesn’t help or possibly in conjunction with GABA support: tonsil issues, hiatus hernia, reflux in 23 -68% of individuals (I would look for the root cause rather than using a proton pump inhibitor/PPI), sinusitis, post-nasal drip, goitre, an actual foreign body, high consumption of alcohol/caffeine/tobacco and cancer (which they state is rare).

Interestingly, speech and language therapy has been shown to improve globus pharyngeus in two studies, possibly due to the reassurance experienced.

The paper concludes as follows:

Finally the link between anxiety and globus sensation must be considered. Evidence supports the use of cognitive behavioural therapy, but very little evidence exists for the use of anxiolytics or antidepressants.

I’ll add to this: the link between low GABA and globus sensation must also be considered, especially if you experience the physical type of low GABA anxiety. GABA to the rescue!

Based on the research, low serotonin, vagus nerve function, thyroid health and h/pylori may also be factors. I suspect food sensitivities play a role. And pyroluria too, because of the additional loss of zinc and vitamin B6 which is needed for GABA production. I’ll leave all this for a follow-up blog.

Have you experienced a globus sensation episode? And what did it feel like?

Did you get a diagnosis or is the term new to you?

Has GABA helped … in the moment or if you look back on your use of GABA for anxiety?

Did you discover other root causes and solutions? Please do share.

Please share if  you have pyroluria and your episodes were triggered by a very stressful event

And feel free to post your questions.

If you’re a practitioner I’d love to hear your feedback too.

Dr. Datis Kharrazian’s GABA Challenge for a leaky blood brain barrier is a theory and we still have much to learn

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gaba challenge theory

I highly respect Dr. Datis Kharrazian and his work and had the pleasure of interviewing him last November on the Anxiety Summit 5: Gut-Brain Axis. During our preparations I asked if we could talk about his GABA challenge for a leaky blood brain barrier and he graciously agreed.

I wanted to address this topic in our interview because two of the most common questions I get asked are these:

  • “How can GABA work if it can’t cross the blood brain barrier?” and
  • “If GABA works does this mean I have a leaky blood brain barrier?”

We had such a great conversation on the topic I’ve decided to pull this part of the transcript into a blog so I can share it here with you and use the blog link to share it more widely as I’m asked these questions on social media and elsewhere.

You will learn how Dr. Kharrazian came up with the GABA Challenge, what his thoughts are today, his reservations with GABA and my excellent results with low doses of sublingual GABA. I also share some links to success stories, some of the research and how to figure out if GABA is for you.

Here it is, word for word.

Trudy: So while we’re talking about the leaky blood brain barrier, I want to just talk briefly about GABA and the GABA challenge that you have proposed as a tool for testing for a leaky blood brain barrier. And as you know, I use GABA extensively with clients with the low GABA physical type of anxiety.

I’ve always been a huge fan of you and your work but we do have a professional difference of opinion in this area. And I’ve never actually been a proponent of using the GABA challenge, and I’ve been pretty vocal about it. So I’m really glad that we had a discussion about this in the Facebook group of your neuroinflammation training, and you shared some insights because I was asking some questions about this.

I’d love you to just share some of what we talked about in that discussion. Because if we don’t talk about it, my community is going to say, “Hey, why didn’t you talk to Dr. Kharrazian about this?”

Dr. Kharrazian: Sure, no problem. I don’t think we have this big a disagreement. I think we just have different ways of looking at what’s out there and what we are observing as people working with people, patients who have anxiety.

So ultimately, we have a bunch of theory right now and a bunch of potential models, but we don’t have any clear studies to show what’s really happening. So, one of the things that I proposed in my book before… you understand, I was working with brain patients for over 20 years now….before we had S100 B readily available for many years, it was only in research; you couldn’t get it from conventional labs, even though research was showing it. And the blood brain permeability test was not available either. These have really become more available the past five years and prior to that, we didn’t really have a great test to evaluate if the blood brain barrier was breached.

In an effort to work with what’s out there, what we could do, one of the things that I was doing was doing a test that we called the GABA challenge test. It was really based on the lactulose mannitol test. So the lactulose mannitol test is a well-established test in gastroenterology where they measure leaky gut. So, in that test what the person does is they consume a monosaccharide and a disaccharide, lactulose and mannitol. Lactulose is a disaccharide, it’s very large, and mannitol is very small. And if mannitol doesn’t get absorbed, then there’s a malabsorption issue. And if lactose, which is very large; that should not get through the tight junctions of the gut, gets absorbed in a post urine test, after they drink it, then it shows they have leaky gut. So the whole premise of when you find particle sizes too large to cross, can be a clue to an indication of permeability.

So the GABA challenge that I write about in my book, Why Isn’t My Brain Working? (my Amazon link) was really a way for us to have patients consume GABA. If you look at the molecular weight of GABA, the Dalton size, it’s several hundred Daltons. Several hundred Daltons cannot cross the blood brain barrier. So the concept was, well if someone is taking GABA and they have an effect, then there’s a potential for it to cross the blood brain barrier. And it was kind of following the theory of the lactulose mannitol test. So there’s patients out there who take GABA and nothing happens and some patients take it and go, “It was amazing. Best thing ever. It finally helped me sleep,” or, “Helped reduce anxiety for me.” So, one of the theories was that maybe for some of these people, their blood brain barrier is breached.

Now I know we talked and there is actually the possibility of other pathways that can impact GABA, maybe directly to the gut itself, through the vagus, so I don’t discount those possibilities because we still don’t know. I mean, ultimately, there’d have to be a study designed where they look at it. And it would have to be an animal study, there’s no way you can get an IRB for human studies to check if it’s crossing the brain. It’s some really advanced isotope tracing techniques and I just don’t think the level of dyes they would have to consume to look at the gut and the brain is peripheral and separate… it wouldn’t be possible. So the real answer is, we don’t know.

For me, I still am always suspicious if someone takes GABA and they have a reaction. I always want to go and check the blood brain barrier. And it’s not 100%, I mean, I can tell you without question, there’s people who take GABA, you do a blood brain barrier test, they feel benefit from it, but their blood brain barrier doesn’t have any markers to show permeability.

So it’s not hard for me to consider the possibility that there’s some exogenous pathways too. But at the same time, it’s also really hard to look at the molecular weight of GABA and look at what can cross a healthy blood brain barrier. This Dalton size, we’re talking nanoparticles to a huge, huge particle. So I don’t know but I think we’ll just have to see what happens. And ultimately, if you feel better with GABA, that’s great. If it’s not harmful to you, and if you feel like taking it, that’s great.

I like to also use things like Valerian root, passion flower, and hops because those compounds cross the blood brain barrier. They cross the blood brain barrier and they bind to GABA receptors.

So, the other thing too with actually using GABA you always have the potential for your neurotransmitter receptor sites to down regulate. And this is seen all the time too, patients take GABA and they feel great and then they have to increase their dose and they don’t get the effect as they first did. And they increase the dose and finally, they just don’t get much of an effect from it. And that’s potentially due to receptor site down regulation, which is not as common if you take agonists like Valerian root or passion flower, or hops. These things bind to GABA receptors. So I did a review in my book, where I went over all the literature of the different GABA compounds, which have been published in the literature.

But I’m not going to deny the possibility that there is a potential exogenous source but I also can’t let go the possibility that the blood brain barrier is permeable. So I’m still waiting.

Trudy: Yes, I think it’s great because the fact that you write about that and you taught about that, and you teach about it. It got me looking into the research further and it got me more curious; and it’s good, it’s good to have a healthy discussion and a healthy debate, and be open to possibilities. I’m very open to having my mind changed if something comes up.

I just see GABA works so well with my clients and we use very, very small amounts. I know with your GABA challenge, it’s… what is the amount, its 1,500 milligrams, I think or 1,500 to 2,000? So I’ll start my clients on 125 milligrams of GABA sublingually and get results. I have not noticed the effect that they need more and more, and more. So that’s interesting that you say that. But yeah, it’s good, I’m glad that we’ve had this discussion.

And the other thing that you did say in the online discussion, you said, if someone has a response to taking oral GABA, in other words, taking a GABA supplement does help them, you would want to test for the blood brain barrier permeability, just to see what’s going on. And I like that you say we can track. I’ve actually been in discussions with Cyrex and said, “Hey, why don’t we monitor people who are doing the Cyrex test and have a response to GABA, either therapeutically for the anxiety or with your challenge?” We may start to see some patterns, which I think would be very interesting.

Dr. Kharrazian: Yes, the best we can do with the data in that scenario is just the correlation statistical analysis. But it still wouldn’t answer it.

Trudy: No, I know. But maybe that will trigger someone to want to do a study. So, the good news is we’re seeing more and more research on GABA in the literature. So, it’s exciting. Well, thank you for discussing that with me.

You can read more from our very enlightening interview here: Fix the Brain to Fix the Gut. Dr Kharrazian covers the impact of brain injury and impaired vagal activity (as well as motility and breakdown of the blood brain barrier), how to activate your neurons, using polyphenols for neuroinflammation and butyrate for leaky gut/brain.

These blogs have additional information on GABA and some of the many possible mechanisms:

Here are some blogs with feedback from folks who have benefited from using sublingual GABA for dental anxiety, ADHD/focus issues and Lyme anxiety:

The best way for you to figure out if you will benefit from GABA is to use the trial method. Do the low GABA questionnaire and do a trial of GABA (used sublingually), starting low and increasing until you find the right amount to ease anxiety and improve sleep. You can find the GABA products I recommend on my supplements blog.

Please do share if you’ve benefited from using GABA or if you use it with success with your clients or patients.

Coronavirus: my immune boosting and antiviral plans (and what to use if you’re anxious)

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coronavirus immunity

 

3/27/20: Updated with a good blog post on elderberry (addressing cytokine storm concerns); an excellent video on “The Coronavirus Explained”; 3 new and promising coronavirus/COVID-19 studies on gut health and melatonin; an excellent hand-washing video I encourage you to watch with your families; a recap on using GABA, tryptophan, DPA, glutamine and tyrosine for emotional support

3/20/20: Updated with webinar information so you can post your questions.

3/12/20: Updated as a result of the situation in Italy and the WHO pandemic declaration – Italy overwhelmed with not enough ICU beds and ventilators; predictions the USA healthcare system (and other countries) will likely not be able to handle a similar situation; stay home and immune-boosting advice from Dr. David Brady; additional resources from Dr. Elisa Song; and more on hand-washing

1/31/20: Originally published – vitamin C and foundational nutrients; my other immune boosting nutrients and first aid kit; GABA or tryptophan if you are worried, overly anxious or fearful

UPDATES 3/27/20:

Coronavirus explained, gut health, elderberry, melatonin and more

So much is changing so quickly and there is so much to learn about the coronavirus. I am spending all my time pouring through the literature, learning from other practitioners, reaching out to researchers and trying to connect some of the dots for you. For this reason I’ve decided to do an update each week to this blog and add new findings and relevant information for you.

I’ve updated this blog again TODAY with a good blog post on elderberry, an excellent video on “The Coronavirus Explained” and 3 new and promising coronavirus/COVID-19 studies on gut health and melatonin. I will be taking a deeper dive into these studies, sharing my perspectives related to the anxiety nutrition work I do. I also share an excellent hand-washing video I encourage you to watch with your families!  And a recap on using GABA, tryptophan, DPA, glutamine and tyrosine for emotional support.

Elderberry concerns about it triggering a cytokine storm – put to rest

There have been many questions about elderberry and concerns about it possibly triggering a cytokine storm. Suzy Cohen addresses all these concerns here: In Defense of Precious Elderberries

The misinformation you’re getting was based upon a research article that evaluated blood cells in test tubes. It was not a well-designed, placebo-controlled clinical trial. It was not even done on real live people (in vivo).

A number of my respected colleagues agree with her conclusions: “compounds from elderberries can directly inhibit the [flu] virus’s entry and replication in human cells, and can help strengthen a person’s immune response to the virus.” More here.

Understanding the Coronavirus

I found this video very helpful for understanding the coronavirus: The Coronavirus Explained & What You Should Do

 

New and promising coronavirus/COVID-19 studies on gut health

Here are two new coronavirus/COVID-19 gut health studies. I will be taking a deeper dive into these studies in a future blog post, sharing my perspectives related to the anxiety nutrition work I do. For now, here are the links.  It’s very preliminary research but if you tuned in to the recent Anxiety Summit 5: Gut-Brain Axis, you know how promising this is:

Although no specific antiviral treatment has been recommended to date, we speculate that probiotics may modulate the gut microbiota to alter the gastrointestinal symptoms favorably and may also protect the respiratory system

Nutritional and gastrointestinal function should be assessed for all patients. Nutritional support and application of prebiotics or probiotics were suggested to regulate the balance of intestinal microbiota and reduce the risk of secondary infection due to bacterial translocation.

Anxiety and fear were common in patients with COVID-19. Therefore, we established dynamic assessment and warning for psychological crisis.

I address anxiety in all the work I do an agree it needs to be at the forefront for everyone.  I take a deeper dive into GABA and theanine and the anxiety/sleep/immunity connections in this recent blog: GABA and theanine for easing anxiety, improving sleep and supporting immunity.

Melatonin as a potential treatment: new research

This in press and pre-proof paper on melatonin is also very promising: COVID-19: Melatonin as a potential adjuvant treatment:

Melatonin, a well-known anti-inflammatory and anti-oxidative molecule, is protective against ALI/ARDS [acute lung injury/acute respiratory distress syndrome] caused by viral and other pathogens. Melatonin is effective in critical care patients by reducing vessel permeability, anxiety, sedation use, and improving sleeping quality, which might also be beneficial for better clinical outcomes for COVID-19 patients. Notably, melatonin has a high safety profile.

I will also be taking a deeper dive into this study in a future blog post, sharing my perspectives on serotonin, melatonin, anxiety and sleep.

THE best hand-washing video!

This is THE best hand-washing video I’ve come across. It was even retweeted and acknowledged by WHO Director General, Dr Tedros Adhanom Ghebreyesus.

I’m pretty sure I may have been missing my thumbs! What about you?

handwashing

I don’t know how to share a video from twitter other than share the twitter link so I hope you can watch it.

We’re using soap at home and have one designated person in our household of four adults going out to pick up food items. This is the time we use hand-sanitizer (and gloves). Here is another blog on How to Make Your Own Hand Sanitizer in case you’re in a similar situation to us and can’t find ingredients to make more. Suzy mentions vinegar and colloidal silver in this one and shares a number of practical recipes.

IV vitamin C, oxalates, anti-malarial drugs and losss of smell and taste

It’s so encouraging that New York hospitals are treating coronavirus patients with vitamin C.  There are, however, concerns for folks who have dietary oxalate issues (with both oral and IV vitamin C). I’ve been gathering feedback and research on this topic and will hopefully have more to share next week.

I also have some major concerns about the anti-malarial drugs chloroquine and hydroxychloroquine and will share those, together with my perspectives on the loss of smell and taste as a possible marker of infection.

 

bouquet of hope

Until then, here is another little “bouquet of hope” from our garden to you … My darling mom-in-law brought this lovely little arrangement to me in my home office earlier this week! Aren’t I a lucky girl!?

Amino acids for emotional support, good sleep and to prevent comfort-eating

Finally, don’t forget about the amino acids for added emotional and nutritional support (our needs are higher at a time like this):

  • GABA for physical tension and anxiety (more here)
  • tryptophan for excessive worrying and feeling fearful (more here)
  • glutamine if you’re not eating well and getting blood sugar crashes, and for gut healing (more here)
  • tyrosine if you just can’t focus and want to curl up in bed (more here)
  • and DPA if you’re feeling overly emotional and weepy, comfort-eating is your support right now (more here)

This blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the products that I use with my individual clients and those in my group programs.

Please feel free to comment on any of the above new developments and share what you are learning too. And do let me know if this format is helpful for you.

Keeping you in my thoughts! And keeping you informed and empowered so anxiety is less of an issue.

UPDATES 3/20/2020:

I’m planning a series of webinars to get your coronavirus questions answered:

  1. I’m planning to interview a health coach/colleague living in Italy/Germany right now and have her share her experiences about living in lock-down and more about the situation in Europe
  2. I’m planning to interview Dr. David Brady to share his patient protocols for immunity,  testing and much more
  3. I’ll be doing one with me talking about best how to deal with the anxiety, worry and laying awake until 3am fearful.  Anxiety and lack of sleep adversely impact immunity so we have to sort that out. I’ll also cover the many nutrients for anxiety that also support immunity
  4. I’m looking for an expert to talk about vitamin C and the risks for those with dietary oxalate issues, and other viable and safe options instead of vitamin C
  5. I’ll be interviewing a doctor on the role of melatonin in counteracting severe inflammatory responses such as pro-inflammatory cytokines. It’s being theorized that older individuals are being more impacted because of low melatonin levels and it’s because children have higher levels of melatonin they are less impacted.

I hope these will be helpful for you? What questions do you have for each webinar (please list the webinar # and the question/s when you comment below. Please don’t send your questions via email – as you can imagine we are receiving a large number of emails!) Let me know what other information you are looking for.

UPDATES 3/12/2020:

The situation in Italy has me concerned

At the time of initial publication of this blog at the end of January, I was in agreement with what the Orthomolecular Medicine News Service were suggesting – we were reading a lot of media hype.

I am not one for fear-mongering, but after reading this very sobering account by two Italian doctors 2 days ago, I am now much more concerned about the coronavirus for the folks who will be most severely impacted – the elderly and the immune-compromised.

In Italy they do not have enough ventilators or ICU beds. Dr. Jason Van Schoor shared warnings from a colleague working in Northern Italy:

I feel the pressure to give you a quick personal update about what is happening in Italy, and also give some quick direct advice about what you should do.

First, Lombardy is the most developed region in Italy and it has a extraordinary good healthcare, I have worked in Italy, UK and Aus and don’t make the mistake to think that what is happening is happening in a 3rd world country.

The current situation is difficult to imagine and numbers do not explain things at all. Our hospitals are overwhelmed by Covid-19, they are running 200% capacity

We’ve stopped all routine, all ORs have been converted to ITUs and they are now diverting or not treating all other emergencies like trauma or strokes. There are hundreds of pts with severe resp failure and many of them do not have access to anything above a reservoir mask.

Patients above 65 or younger with comorbidities are not even assessed by ITU, I am not saying not tubed, I’m saying not assessed and no ITU staff attends when they arrest.

We have seen the same pattern in different areas a week apart, and there is no reason that in a few weeks it won’t be the same everywhere

You can read the entire thread on Twitter here. At first glance there is skepticism and disbelief this could be happening but a trusted colleague in San Francisco has heard similar accounts from doctors she knows in Italy. It’s thanks to her that I started digging deeper into the situation in Italy and had my mind changed.

And this article in the New York Times was also just published confirming much of this: Italy’s Health Care System Groans Under Coronavirus — a Warning to the World. They they do mention doctors being muzzled which is very concerning. We need transparency if we are to learn.

Predictions the USA healthcare system (and other countries) will likely not be able to handle a similar situation

This article supports what is happening in Italy, with serious predictions for the USA (and presumably other countries too) – What does the coronavirus mean for the U.S. healthcare system? Some simple math offers alarming answers

What does an avalanche of uncharacteristically severe respiratory viral illness cases mean for our health care system? How much excess capacity currently exists, and how quickly could Covid-19 cases saturate and overwhelm the number of available hospital beds, face masks, and other resources …

….like in Italy where this is happening right now!

This is why I am now fully behind social distancing and staying home

I’m still of the opinion I need to focus on healthy living/eating and boosting my immunity (and it’s what me and my family are currently doing) but I am now fully behind social distancing, staying home, not attending big events and not traveling – so this virus can be contained as much as possible. Knowing what I now know about Italy makes this an easy decision which is why I’m sharing it here today – even if it is frightening.

Dr. David Brady, ND, author of The Fibro Fix, provides some basic advice on staying as healthy as possible in this recent video posted on Facebook. His is the calm voice of reason, sharing precautions to take during the COVID-19 pandemic and also fully supporting the social isolation and stay home message.  He does mention andrographis for antiviral support, garlic, elderberry, vitamin C, lauric acid (monolaurin), vitamin D, preformed vitamin A (as opposed to beta-carotene), zinc and echinacea as all good nutrients to consider for his patients and family.

Unfortunately, many of my colleagues are still saying it’s media hype, out of control fear-mongering, is not as bad as the flu and there is no way this could happen in a country like the USA, Australia, UK and elsewhere.  I know they’ll get on board with all this once they have this information too.

I sincerely hope I am wrong about this and things don’t get as bad as Italy. For now I’m playing it safe.

My hand-washing research

I got called out for not mentioning hand-washing when I first published this blog. My focus was to share my first-aid kit i.e. nutraceuticals I use but KT was is absolutely right

Hand hygiene is the single most important intervention for reducing healthcare associated infections and preventing the spread of antimicrobial resistance.

My assumption was that this is common knowledge but based on this statement in the same paper, perhaps this isn’t the case?

while tremendous progress has certainly been made in this field, a significant amount of work is yet to be done in both strengthening the evidence regarding the impact of hand hygiene and maximizing its implementation

With regard to what to use: antibacterial soap showed little added benefit compared with regular soap

Interestingly this paper also states “Hand hygiene is clearly effective against gastrointestinal and, to a lesser extent, respiratory infections. Studies examining hygiene practices during respiratory illness and interventions targeting aerosol transmission are needed.” I’m not sure of the implications of this for the coronavirus. For now I’m following the guidelines outlined in Dr. Song’s blog (below).

This 2017 Time article, Washing Hands In Cold Water Works As Well As Hot Against Germs, clears up what they say is often conflicting data and has some good guidelines from a study published the same year (it was looking at E. coli bacteria and not viruses): wash hands in cold water, at least 10 secs of lathering and use regular soap. Hand lotion afterwards seems to help too.

Additional resources

I’ve also got some blogs from colleagues to share with you so you have additional resources:

It’s an approach the physicians of the Orthomolecular Medicine News Service are recommending and it’s gives me a higher level of comfort in these days ahead.

As I mentioned above I do have some questions and concerns about this vitamin C IV approach (and high doses of oral vitamin C) for folks with oxalate issues (myself included) and for folks with G6PD deficiencies and hemochromatosis. I’ll share more as I learn more.

  • And this one from Dr. Song too – Handwashing and Coronavirus: Are you doing it the right way? I encourage you to watch the hand-washing demo videos she links to and show them to your children! This fact is astounding: “If 60% rather than 20% of air travelers maintained clean hands, it could slow down the spread of infections by almost 70%“
  • Dr. Song also shares How to Make a 60% Alcohol-Based Hand Sanitizer. “Washing hands with soap and water is the #1 recommended way to prevent the spread of Coronavirus. But if you don’t have access to soap and water, what can you do? The CDC recommends using a hand sanitizer with at least 60% alcohol.“
  • A blog from Paleohacks: Thieves Oil What It Is, Benefits & How to Make It. Use Thieves oil as a natural disinfectant around your home. “It’s great for wiping down counters, cleaning toys, disinfecting cutting boards, removing stale odors, freshening trash cans and gym bags, and even cleaning veggies.”

Originally published 1/31/20:

How are you handling all the coronavirus news? Worried? Anxious? Fearful? Or are calmly watching and listening and making sure your immune system is in good shape and you have natural antivirals on hand if necessary? (and updated 3/12/20 – are you taking the stay at home message seriously? much more on that below)

There are still many unknowns but I’ve been gathering some articles and resources for my own personal use. I’m not an expert in infections but since folks in my community are asking I promised to share my first-aid kit and rationale in a blog post.

I can help with the anxiety and fear aspect if all this doesn’t put your mind at ease. I cover how I use individual amino acids with my clients at the end of this blog post.

Vitamin C and other foundational nutrients

This newly published blog by Andrew Saul PhD, Vitamin C Protects Against Coronavirus, offers sage foundational advice that resonates with what I already know:

The physicians of the Orthomolecular Medicine News Service and the International Society for Orthomolecular Medicine urge a nutrient-based method to prevent or minimize symptoms for future viral infection. The following inexpensive supplemental levels are recommended for adults; for children reduce these in proportion to body weight:

Vitamin C: 3,000 milligrams (or more) daily, in divided doses.

Vitamin D3: 2,000 International Units daily. (Start with 5,000 IU/day for two weeks, then reduce to 2,000)

Magnesium: 400 mg daily (in citrate, malate, chelate, or chloride form)

Zinc: 20 mg daily

Selenium: 100 mcg (micrograms) daily

Vitamin C, Vitamin D, magnesium, zinc, and selenium have been shown to strengthen the immune system against viruses.

Additional rationale for vitamin C

In another blog by Andrew Saul PhD, Nutritional Treatment of Coronavirus, offers additional rationale for vitamin C: “Abundant clinical evidence confirms vitamin C’s powerful antiviral effect when used in sufficient quantity” and states that the “physicians on the Orthomolecular Medicine News Service review board specifically recommend at least 3,000 milligrams (or more) of vitamin C daily, in divided doses. Vitamin C empowers the immune system and can directly denature many viruses.”

It’s very encouraging to read that just 200mg a day“given to the elderly resulted in improvement in respiratory symptoms in the most severely ill, hospitalized patients.”

This statement from the above blog puts much of what is considered to be media hype and fear-mongering into perspective: (see below why I no longer feel this is media hype)

“The common cold is a coronavirus, and SARS is a coronavirus, so they are the same viral type” ~ David Jenkins, MD, Professor of Medicine and Nutritional Science, University of Toronto.

I do have some questions and concerns about using high doses of oral vitamin C and vitamin C IV for folks with oxalate issues (myself included). I’m actively seeking answers.

Vitamin D, olive leaf extract, oregano oil, elderberry, NAC and diet

Here are some additional links that I have found or were shared with me (thank you if you shared one of these with me!):

  • Vitamin D and the anti-viral state “These results support the hypothesis that vitamin D … may play a major role in the inhibition of viruses.” I’m very aware of the immune-boosting properties of vitamin D.
  • Olive leaf extract “decreased the duration of upper respiratory illness in high school athletes.” We always have this on hand and it appears to work well for me and my family so I’ll make sure to keep this in mind.
  • Oregano oil – per this article on Holistic Primary care “A number of preliminary in vitro or animal studies have shown that compounds in oregano oil are virustatic and virucidal against several viral pathogens.” I always have oregano oil on hand (and especially when flying) and it always works well for me at the first sign of any bug. I was pleased to come across this research even though we don’t yet have a human study.
  • Black elderberry liquid extract “displays an inhibitory effect on the propagation of human pathogenic influenza viruses” and has antimicrobial effects against bacteria responsible for infections of the upper respiratory tract. This is also a firm favorite in our household in the winter months and I seldom need more than one or two doses at the first sign of the sniffles.
  • N-acetyl-L-cysteine (NAC) “antioxidants like NAC represent a potential additional treatment option that could be considered in the case of an influenza A virus pandemic.” I’ll be giving NAC more consideration.
  • Here are some well-balanced perspectives from Peter D’Adamo on Facebook mentions drinking plenty of water, stocks, garlic (freshly crushed), onions, leeks, elderberry and Andrographis paniculata. He does say “Keep in mind these are just my opinions and observations over a thin veneer of facts.”

Consider lomatium?

Lomatium is not my first choice but I’m listing it here out of interest. Lomatium by Barlow Herbals “During the flu pandemic of 1917-1918, the root came into extensive use by the two Washoe Indian tribes near Carson City, Nevada.” I have yet to try this one but have heard Jane from Barlow Herbals talk about lomatium on a number of summits and I’m intrigued.

My first-aid kit

In summary, here is my first-aid kit: Vitamin C, zinc, extra selenium, vitamin D, magnesium, oil of oregano, olive leaf extract, black elderberry and Biocidin Throat Spray and Xlear Nasal Spray (the latter two are always on hand and I always also travel with them).

I also always have essential oils on hand: tea tree oil, eucalyptus, peppermint, rosemary, lavender and others. I’ll be adding sage per Dr. Elisa Song’s blog (see below).

This is pretty much what I always use other than adding in extra selenium, so it was very affirming to gather all this research.

trudy first aid kit
Here are just a few products from my first-aid kit.

GABA or tryptophan: if worried or overly anxious or fearful

If you’re feeling worried or overly anxious or fearful, the best way is to be informed and prepared. Interestingly, some of the very same nutrients mentioned above also help ease anxiety – vitamin C, zinc, vitamin D, magnesium and selenium and B vitamins – because they are co-factors for making neurotransmitters like serotonin, GABA and dopamine.

If all this information and being prepared isn’t enough to calm you down, then don’t forget the individual amino acids for quick relief. I use GABA for clients who are feeling physically tense and tryptophan or 5-HTP for worry-type of anxiety and if they are imagining the worst and can’t switch off their busy mind off.

We use the trial method to find the ideal amount for each person, starting low and titrating up based on symptoms and then down if not added benefits are seen.

You can find my most popular amino acid products on the supplements blog here (and with details for how to set up an account for my online store). You can find everything else I write about in the store too. Just be sure to work with your practitioner.

My thoughts are with you and all of those currently ill and those who will get ill. We will get through this together.

My hope is that you are less anxious and fearful as you become more informed.

Please share your immune-boosting remedies and your thoughts and plans.

As I mentioned above, these are resources and information I’ve gathered for my own personal use, and are in no way intended to be recommendations.

 

How high to go on GABA for sleep issues and what are the negative effects of too much tyrosine?

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gaba and sleep issues

How high to go on GABA for sleep issues and what are the negative effects of too much tyrosine?

Today I’m sharing a great question I received about sleep issues – how high to go on GABA and what are the negative effects of too much tyrosine – together with my feedback because it’s not always a simple answer.

Here is the question about sleep, GABA and tyrosine:

I find I need more than the 500mg of sublingual Gaba Calm for sleep even with 200mg theanine. What dose can I go up to. Took a while to work up to that dose. I want to get away from sleeping tablets. Also what are the negative effects of too much tyrosine that comes with this product?

GABA Calm contains both GABA (125mg) and tyrosine (25mg) and it’s one of my most recommended products for anxiety. It sometimes works for insomnia and sometimes it doesn’t.

GABA and feeling stiff and tense with insomnia and anxiety

As you may know, with sleep issues caused by low GABA levels you’ll often lie awake with feelings of physical tension and stiff muscles rather than the ruminating thoughts which is the low serotonin type of insomnia – although it’s not uncommon to experience both. You may also have the stiff-and-tense type of anxiety, panic attacks and the need to self-medicate to calm down, often with alcohol but sometimes with carbs and sugary foods. By using the amino acid GABA you can raise your GABA levels and ease many of these symptoms.

Tyrosine can be stimulating and can be calming

Tyrosine is a considered a stimulating amino acid that is the precursor for making catecholamines (one of the neurotransmitters) like dopamine, epinephrine and norepinephrine. Boosting these neurotransmitters provides focus, increased energy and more motivation, and can also alleviate some forms of “curl-up-in-bed” depression.

Conversely tyrosine can also provide a sort of calm focus for some folks.

How much GABA and how much tyrosine?

Keeping all the above in mind, here is my feedback: 500mg of GABA is a large dose when starting out and is typically too high for most people, causing a light-headed feeling and sometimes a niacin-like flush. For this reason, it was good to hear that she worked up to that dose of GABA, found in 4 of the GABA Calm tablets i.e. 125mg of GABA for each one.

When my clients get up to multiple GABA Calm tablets I will often have them switch to a GABA-only product or a GABA/theanine product (opened up onto the tongue and held there for 2 minutes or longer) as the tyrosine can be stimulating. Some folks do fine on a small amount of tyrosine in the evening so 1-2 GABA Calm may be fine but more than that and it can be too much and may need to be avoided.

Taking 4 x GABA Calm tablets also provide a hefty dose of sugar alcohols which could cause diarrhea.

As far as using higher amounts of GABA, I have clients increase as long as they are seeing added benefits. I have had some clients go up to 1000-2000mg but more than this is rare. Theanine can often also be increased up to around 1000mg.

Here are some clues to look out for:

  • too tired in the day → too much GABA or too much theanine?
  • too tired in the day → too little GABA or too little theanine causing disturbed sleep?
  • too tired in the day → not enough tyrosine?
  • not able to sleep well → too little GABA or theanine?
  • not able to sleep well → too much tyrosine (at night or even mid-afternoon)?
  • calm energy → just enough tyrosine
  • sleep well → just enough GABA and/or theanine

There is research supporting that a GABA/theanine combination can improve sleep and that a GABA/5-HTP combination can too. There is no research on GABA Calm and insomnia but in practice it works for some people at night and not for others.

I’m sure you can agree with me that it’s not always simple and there can never be one size fits all. This doesn’t work: “Since you have insomnia take 2 GABA Calm and I’ll see you in a month” or even “This 250mg GABA with 100mg theanine will sort out your sleep issues in no time.”

It’s always a matter of figuring out what your own unique needs are.

Looking for other root causes of your insomnia

If my clients are not seeing incremental benefits as they increase the GABA and/or theanine (and stop the tyrosine) they go back down to their lower dose and we start looking for other root causes for their insomnia.

These root causes can range from low serotonin to high cortisol, also gut issues like SIBO, parasites (which are more active at night) or gluten issues. Too much caffeine (even if consumed in the morning and even a single cup of coffee!) and low blood sugar must always be ruled out too. Some sleep medications can actually make sleep worse especially benzodiazepines. And side-effects of all medications need to be looked at and also the possible effects of EMFs/WiFi.

Have you found that using the trial method with GABA and/or theanine has enabled you to find the ideal amount to take for your insomnia or anxiety? Where did you start and how high did you need to go and how much did this approach help?

Did the removal of tyrosine make a difference or make you more tired in the day?

Were there other factors at play as root causes of your insomnia or anxiety?

As a practitioner, do you want to learn more about how to incorporate GABA and theanine and the other targeted individual amino acids, tryptophan/5-HTP, DPA, glutamine and tyrosine, into your work to help your clients/patients with sleep issues and anxiety? I invite you to check out my new online practitioner training here: Balancing Neurotransmitters – The Fundamentals. I’m extending the $100 discount offered at IMMH for a few weeks (use coupon code immh2019).

IMMH highlights: mold, oxalates, anxiety, panic attacks and depersonalization

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IMMH highlights

Today I’m sharing some highlights from three different presentations at the recent IMMH/Integrative Medicine for Mental Health Conference – on mold and the connection to oxalate issues, as well as a major trigger of anxiety, panic attacks, depression and depersonalization.

Matthew Pratt-Hyatt, PhD: “The Hidden Threats of Mycotoxins.”

Matthew Pratt-Hyatt, PhD presented on “The Hidden Threats of Mycotoxins.” He shared medically significant mycotoxins and that ochratoxin affects the kidneys and my first thought was: “I wonder if this plays a role in oxalate issues?”

I asked Dr. Pratt-Hyatt after his presentation and he said yes, the mycotoxins produce oxalates and then dietary oxalates can be the tipping point. He wasn’t aware of any research on the mycotoxin-oxalate connection but sees the connection on the Great Plains MycoTOX lab test and Organic Acids test

Matthew Pratt-Hyatt

Matthew Pratt-Hyatt

Matthew Pratt-Hyatt

Matthew Pratt-Hyatt

Dr. Neil Nathan: “Mold Toxicity as an Unrecognized Cause of Mental Health issues.”

One of my favorite presentations was the one delivered by Dr. Neil Nathan on “Mold Toxicity.” He defines mold toxicity and how it can directly trigger anxiety, panic attacks, depression, depersonalization and hallucinations, as well as some of the common complications which can exacerbate mental health symptoms. These include mast cell activation, multiple chemical sensitivities, secondary porphyrias, methylation dysfunction and pyroluria.

I do appreciate the fact that he addressed that there can be PTSD caused by physicians when someone knows they are sick – especially with mold toxicity – and yet they do not feel heard or validated. This can even lead to their families being less supportive.

Dr. Nathan is a brilliant and compassionate practitioner, and the author of the excellent book – Toxic: Heal Your Body from Mold Toxicity, Lyme Disease, Multiple Chemical Sensitivities, and Chronic Environmental Illness (my Amazon link)

Neil Nathan

Neil Nathan

Neil Nathan

Neil Nathan

Neil Nathan

Dr. Kurt Woeller: “Metabolic Products in Mental Health – How Fungal, Bacterial, Mitochondrial and Other Compounds Influence the Brain.”

Dr. Kurt Woeller shared more about oxalates and mold in his presentation: “Metabolic Products in Mental Health.” I really like the Oxalate Metabolism diagram that shows the role of low vitamin B6, dietary oxalates including ascorbic acid, collagen and gelatin, mold, yeast and genetics in someone with high oxalates.

On a side note, low serotonin is often a factor with collagen and gelatin but it can be a source of oxalates.

He mentions various health problems associated with high oxalates – pain issues are common and so is fatigue and behavioral issues. Dr. Woeller works primarily with children but I have seen anxiety and depression in adults with oxalate issues too.   If mold is one of the triggers then the mental health issues can be further impacted.

 

In case you missed the previous two IMMH blogs:

What wasn’t discussed were some of the other mechanisms that may be causing the increased anxiety – such as the impacts of toxic mold on neurotransmitters and low levels of zinc.

Have you been exposed to toxic mold and was this a trigger for your anxiety, panic attacks and other mood issues?

Did GABA, tryptophan and zinc (and other nutritional support approaches) help ease some of the anxiety symptoms while you were remediating your home and detoxing from the mold toxicity?

Do you have oxalate issues and have you ruled out the fact that toxic mold may be a trigger? I personally have oxalate issues (I share more about this here) and plan to do the MycoTOX test to learn more. I’ll keep you posted on what I find.

As a practitioner, do you want to learn more about how to incorporate GABA and the other targeted individual amino acids, tryptophan/5-HTP, DPA, glutamine and tyrosine, into your work to help your clients/patients with anxiety triggered by toxic mold? I invite you to check out my new online practitioner training here: Balancing Neurotransmitters – The Fundamentals. I’m extending the $100 discount offered at IMMH for a few weeks (use coupon code immh2019).

GABA and theanine mixture improves sleep and eases anxiety

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gaba theanine sleep

I’m at the Integrative Medicine for Mental Health Conference and am speaking on “GABA for anxiety, insomnia, ADHD, autism and addictions.”

One of the studies I will be sharing is this new study on GABA and theanine and how this combination improves sleep: GABA and l-theanine mixture decreases sleep latency and improves NREM sleep.

The authors share the sleep and anxiety benefits of both GABA and theanine:

γ-Aminobutyric acid (GABA) is the main inhibitory neurotransmitter and it is well established that activation of GABAA receptors favours sleep.

l-Theanine, a naturally occurring amino acid first discovered in green tea, is a well-known anti-anxiety supplement with proven relaxation benefits.

The study objective was to investigate the:

potential synergistic sleep enhancement effect of GABA/l-theanine mixture.

The GABA/l-theanine mixture showed a decrease in sleep latency (length of time to fall asleep) and an increase in sleep duration compared to GABA or theanine alone.

The study authors state:

The increase in GABA receptor and GluN1 (glutamine receptor subunit) expression is attributed to the potential neuromodulatory properties of GABA/l-theanine combination, which seems to affect sleep behaviour.

Here are the amounts used in the study:

  • GABA: 100mg per kg of body weight
  • theanine: 20 mg per kg of body weight

I have found the combination of GABA and theanine to be extremely helpful for many of my clients but not everyone needs the combination. Some folks do very well on GABA alone and some folks do really well on theanine alone.

Keep in mind I do not make amino acid recommendations based on weight but instead use the trial method to find the ideal amount.

The best way for you to figure out if you will benefit from the combination or either of them alone is to use the trial method. Do the low GABA questionnaire and do a trial of either GABA alone or theanine alone or a combination of both, until you find the right amount to improve your sleep and ease anxiety.

If you find the combination works well for you, GABA T-SAP by Nutritional Fundamentals, is a really nice combination product that I use with clients who have both anxiety and insomnia issues. I find that opening up the capsule onto the tongue is more effective than swallowing it. You can find this product and other GABA products I recommend on my supplements blog.

Here are some other blogs on the benefits of using oral GABA

Have you found GABA alone to help you with both sleep and anxiety or have you found that the combination of GABA and theanine is more helpful?