GABA

GABA for bladder pain/interstitial cystitis and urgency, IBS pain and anxiety?

January 29, 2021 By Trudy Scott 8 Comments

Is there a place for using the amino acid GABA as a supplement to help with bladder pain/interstitial cystitis and urgency and also help with IBS (irritable bowel syndrome) pain – at the same time as easing physical anxiety caused by low GABA levels?

I’d like to share some quotes from this commentary, GABA_B receptors in the bladder and bowel: therapeutic potential for positive allosteric modulators?

The bladder pain syndrome (or interstitial cystitis/painful bladder syndrome) is a spectrum of urological symptoms characterized by frequency, urgency and pain on bladder filling.

Bladder pain syndrome is often present in those who have IBS and abdominal pain and the authors mention the role of GABA in both:

Of further note is the co-morbidity between bladder pain syndrome and other functional pain syndromes, in particular, irritable bowel syndrome, a functional gastrointestinal disorder associated with visceral abdominal pain and altered bowel habit.

… it is tempting to speculate that GABA_B receptor positive allosteric modulators may display efficacy in not only functional pain disorders of the bladder, but also of the bowel, through modulation of either central and peripheral GABA_B receptors, or both

Positive allosteric modulators increase the activity of the receptor so in this case they are referring to increasing the activity of the GABA_B receptor, reducing both bladder pain and gut pain.

This commentary and the original paper refer to ADX71441, which has been shown in animal studies to be “a novel positive allosteric modulator (PAM) of the GABA_B receptor that has shown encouraging results in pre-clinical models of anxiety, pain, overactive bladder and alcohol addiction.”

We know GABA eases anxiety and pain and is extremely beneficial when it comes to alcohol and other addictions. In a recent blog post I shared how PharmaGABA eases physical anxiety in a young man who has recently given up Adderall, alcohol and nicotine.

And given that depression, anxiety and stress is higher in women with urinary incontinence it makes sense that an amino acid such as GABA may also help ease some of the symptoms of bladder pain syndrome when low GABA is a factor.

Depending on the root cause/s it’s likely addressing low serotonin, low endorphins and low vitamin D may play a role too. Of course, a full functional medicine and nutritional work up and review of diet is key too. Bladder dysfunction is seen in up to one third of celiac patients. This can cause leaky gut and nutritional deficiencies leading to low levels of neurotransmitters such a GABA and serotonin. Dietary oxalates can often be a factor with bladder issues and pain.

Considering all of this in conjunction with learning from/working with a pelvic floor physical therapist is key. I highly recommend someone like Isa Herrera, MSPT, CSCS who hosts online masterclass training sessions for those with pelvic health issues. Her next series airs online mid-February and you can learn more and register here.

Here are some related blog posts that you may find helpful:

How GABA eases agonizing rectal pain and spasms in under 2 minutesProctalgia fugax is described as a condition that leads to rectal spasms and sharp fleeting pain in the lower rectum or anus….and GABA can ease the severe pain or prevent the spasms before they get severe

How to address rectal spasms with GABA, pelvic floor work, gluten removal and squats

GABA reduces the visceral pain of IBS & SIBO, eases anxiety and helps with insomnia

In case you’re new to GABA you can read more about it here: GABA for the physical-tension and stiff-and-tense-muscles type of anxiety.

The supplements blog lists GABA products I use with clients and recommend to those in my community.

I’m proposing that there is a place for doing a trial of the amino acid GABA (as a supplement) to help with bladder pain/interstitial cystitis and urgency, especially when there are symptoms of low GABA. If GABA helps to ease the visceral pain caused by IBS/SIBO, it may also help with bladder pain.

Have you observed less bladder pain when using GABA for easing physical symptoms of low GABA anxiety (stiff and tense muscles, overwhelm, lying awake tensely at night, anxious and using alcohol to self-medicate in order to calm down)?

Have you noticed any reduction in bladder urgency when using GABA for anxiety?

Do you also have IBS pain or SIBO (small intestinal bacterial overgrowth) pain that is eased by GABA?

Have the following helped: going gluten-free, lowering oxalates and/or working with a pelvic floor physical therapist?

If you’re a practitioner have you made any of these observations?

Please do share in the comments below and let me know if you found this helpful, what else has helped you or if you have questions.

GABA Calm is in short supply – what other GABA products are there for easing anxiety?

January 22, 2021 By Trudy Scott 67 Comments

Sheila contacted me via the blog asking about Source Naturals GABA Calm ~ I am from Brussels/Belgium. I cannot find the Source Naturals GABA Calm sublingual anymore. The one you recommend. I’ve been recommending this for years to clients since I read your book “The Antianxiety Food Solution.” I already contacted Source Naturals a few times but no response. Do you know why they have stopped selling this in Europe?

After doing some checking around and contacting Source Naturals it seems there is a world-wide shortage of Source Naturals GABA Calm 125mg lozenges. When I reached out to them I was told it’s indefinite (with no reason why) and to check back at the end of January. Two other people were told it would be available mid-January and mid-February so the messages are mixed.

Today I’m sharing some other GABA product options until GABA Calm comes back or in case it doesn’t or if there is another shortage in the future. It’s such a pity since it is so effective for so many folks as you can see in these blogs:

I also posted this message on Facebook to let my community there know and to find out what they were using instead.

This is some of the feedback I received:

Mary ~ Oh my goodness! I just found it in my local Vitamin Shoppe tonight! There was one bottle left.
Diana ~I noticed. My son uses this, I’m a little worried.

I shared that there are other products that will hopefully work as well and asked everyone who was using something else: Do you use it opened onto the tongue or swallowed? And if you’ve used Source Naturals GABA Calm in the past how does it compare for you?

A number of people said they like Thorne pharmaGABA capsules, someone said she like Now GABA Powder and a few people like Natural Factors pharmaGABA chewables:

Tara ~ I’ve only used Thorne PharmaGABA because of how it’s derived [fermented]. I just swallow the capsule and I’m immediately calm within 5-15 mins. I was previously prescribed a benzo & this is much better. 100mg is all I take when I feel a panic attack coming on. I’ve been thru a few years of absolute hell of benzo withdrawal coming off of my klonopin prescription. The GABA feels almost the exact same as the benzo except the benzo would actually cause rebound panic attacks (I didn’t realize it at the time) & the GABA does not.
Jane ~I use Now Foods GABA powder. A little under the tongue works well.I have found both effective. Powder good for rapid effect at home (1/4 teaspoon as needed). GABA Calm good to take out with you.
Meesh ~ I use the Natural Factors pharmaGABA (100mg) and it works great. I use it in combo with L-theanine 250mg (which also contains 20mg of magnesium)… and the combination is magic

I’ve updated the supplements blog with the above products and a few additional similar products so you have many options to select from based on your unique needs and taste preferences, and what’s available at the time:

Thorne PharmaGABA-100: the label says Gamma-Aminobutyric Acid (GABA) 100 mg but it also states that the product uses Pharma Foods International’s Gamma-Aminobutyric Acid (PharmaGABA®). This is also pleasant-tasting when opened on to the tongue and is most effective when used this way.
Thorne PharmaGABA-250: as above but contains 250mg of PharmaGABA®. This is also pleasant-tasting when opened on to the tongue and is most effective when used this way.
Designs for Health PharmaGABA Chewables: gamma-amino butyric acid (pharmaGABA) 200 mg in 2 chewable tablets. It’s quick-acting and convenient like GABA-Calm because it’s chewable. This does contain xylitol, natural flavors, stevia and some other ingredients so taste may be a factor and xylitol can cause gas, bloating and diarrhea when too much is consumed.
Natural Factors PharmaGABA: gamma-amino butyric acid (pharmaGABA) 200 mg in 2 chewable tablets. It’s quick-acting and convenient like GABA-Calm because it’s chewable. However it also contains organic cane sugar and natural fruit flavors so it’s a little too candy-like for my preference, especially if you have low GABA-related sugar cravings. Also 2 chewable tablets – 4g of carbs which is almost 1 teaspoon of sugar!
[January 22, 2021: I’ve included this as a stand-by option for occasional use until Source Naturals GABA Calm is readily available again or if Designs for Health PharmaGABA Chewables are not available.]
Now Foods GABA Powder: 1/4 Level Teaspoon (500mg). This is pleasant-tasting when opened on to the tongue and is most effective when used this way. The only challenge with powder like this is making sure you don’t use too much by mistake. And it’s especially challenging when you only need 100mg.
Quicksilver Scientific Liposomal GABA with L-Theanine: 2ml (4 Pumps) provides (Gamma Amino Butyric Acid) 240mg, L-Theanine 100mg and Phosphatidylcholine 120mg (from purified sunflower seed lecithin). It does contain ethanol so would not be suitable for alcoholics or young children.

I do want to add that Nutritional Fundamentals for Health GABA-T SAP is still a firm favorite of mine: gamma-Aminobutyric acid (GABA) 300 mg, l-Theanine 150 mg. This is pleasant-tasting when opened on to the tongue and works very well when GABA Calm can’t be used (because of the tyrosine or taste or sugar alcohols). It is also often used with GABA Calm – like GABA Calm in the day and GABA-T SAP at night or some combination. I find best results when it is used opened on to the tongue and it offers a feeling of calm focus. It could easily be used as a substitute for GABA Calm in the short-term.

In case you’re new to GABA you can read more about it here: GABA for the physical-tension and stiff-and-tense-muscles type of anxiety.

Is Source Naturals GABA Calm a favorite of yours? And how has it helped you? What have you found works as well – for physical anxiety, tension, insomnia, pain, sugar cravings, muscle spasms – when it’s not available?

If you’ve used a GABA product in capsules, do you use it opened onto the tongue or swallowed? And if you’ve used Source Naturals GABA Calm in the past how does it compare for you?

If you’re a practitioner do you use GABA Calm and/or other GABA products?

Please do share in the comments below and let me know if you found this helpful or if you have questions. And thanks for the questions and contributions so far!

GABA eases anxiety and is protective against metabolic and reproductive disturbances in polycystic ovarian syndrome (PCOS)?

January 8, 2021 By Trudy Scott 22 Comments

This question was recently asked in my online GABA Quickstart group program: What are your thoughts about using GABA with somebody who has polycystic ovarian syndrome (PCOS)? Are there any contraindications? My approach is always the same regardless of your diagnosis – if you have the low GABA symptoms of physical anxiety then it’s worth doing a trial to determine if supplementing with the calming amino acid GABA will help.

What is very interesting is that this rat study, Protective effects of GABA against metabolic and reproductive disturbances in letrozole induced polycystic ovarian syndrome in rats, reports some very specific benefits of GABA being protective against metabolic and reproductive disturbances in PCOS.

Letrozole or Femara, a non-steroidal aromatase inhibitor (i.e. it lowers estrogen production) is used to treat breast cancer in postmenopausal women and it induced PCOS in the rats.

The following benefits were found when GABA was used in the rats with PCOS:

reduced body weight
reduced body mass index
reduced testosterone
a favourable lipid profile
normal glucose tolerance
a decreased number of cystic follicles in the ovaries

These results are profound. But wait for it …”the effects observed with GABA were comparable to that with metformin” with none of the side-effects (which can actually include anxiety, a racing heart, shakiness and depression).

The authors conclude as follows:

The results suggest that GABA treatment has shown protective effects in PCOS and provides beneficial effects either by reducing insulin resistance or by inducing antioxidant defence mechanisms.

The above paper didn’t measure anxiety levels but it’s very common with PCOS. According to this paper, Polycystic Ovary Syndrome: A Review of Treatment Options With a Focus on Pharmacological Approaches

after PCOS is diagnosed, studies show that more than 50% of patients develop prediabetes or diabetes, and there is an increased risk of myocardial infarction (MI), dyslipidemia, hypertension, anxiety, depression, endometrial cancer, and sleep apnea.

So it makes sense that using GABA will also help to ease any anxiety symptoms that are present. As always, look at the low GABA symptoms and if they exist rate them on a scale of 1-10 (with 10 being most severe), do a trial with GABA, and rate your symptoms afterwards, adjusting up or down as needed based on symptom relief.

A quick recap if you are new to GABA, these are the symptoms of low GABA:

Unable to relax or loosen up
Stiff or tense muscles
Feeling stressed and burned-out
Feeling worried or fearful
Panic attacks
Craving carbs for relaxation and calming
Craving alcohol for relaxation and calming
Craving drugs for relaxation and calming
Insomnia *
Have intrusive thoughts, perseverate or have an overactive brain
Or have unwanted thoughts – thoughts about unpleasant memories, images or worries (Updated Nov 17, 2017: new GABA research on intrusive thoughts) *
Inability to prioritize planned actions *
Acrophobia (fear of heights) * – possibly other phobias too
Poor focus *
Rectal spasms *
Burning mouth *
Visceral pain/belly pain with IBS *

(* New additions that are not in my book “The Antianxiety Food Solution”)

Keep in mind that the above PCOS GABA paper was an animal study and GABA was not listed as a treatment option in the second paper above so my approach would be to use GABA for easing the physical anxiety symptoms. At the same time, share this blog and study with your prescribing physician and request if they will work with you to adjust your Metformin as they monitor your testosterone, lipids, glucose, insulin and cystic follicles in the ovaries, as well as weight and body mass index.

I look forward to human GABA PCOS studies in the near future. I also look forward to hearing back from you if you have PCOS and are using GABA for easing your anxiety symptoms AND are also seeing some of the above metabolic and reproductive improvements.

Given the prevalence of PCOS it’s important we use everything at our disposal to help:

Research suggests that 5% to 10% of females 18 to 44 years of age are affected by PCOS, making it the most common endocrine abnormality among women of reproductive age in the U.S. Women seeking help from health care professionals to resolve issues of obesity, acne, amenorrhea, excessive hair growth, and infertility often receive a diagnosis of PCOS.

We must always use a comprehensive approach and this book by my friend and colleague, Amy Medling is wonderful: Healing PCOS.

Do you have PCOS and anxiety and has GABA helped? Have you also observed some of the above metabolic and reproductive improvements?

If you’re a practitioner working with women with PCOS, have you made any of these observations?

I’d also be curious to hear if you see changes in acne severity, amenorrhea (missed periods), excessive hair growth or infertility?

Please do share in the comments below.

GABA helps a stressed young boy with episodes of “choking” or tightening in his throat

December 25, 2020 By Trudy Scott 30 Comments

Earlier this year I blogged about how the calming amino acid GABA is often a solution for both anxiety and globus pharyngeus (lump in the throat) and a mom shared this about her son’s episodes of “choking” or tightening in his throat (to the point that he cannot swallow), especially when school stress gets high:

My son, (8 y.o.) has a history of public school use of physical aversion intervention for behaviors that result from a significant language impairment often reports “choking” or tightening in his throat to the point that he cannot swallow. When school stress gets high, he ceases to swallow his saliva which creates a long period of “spitting” out substances including food and natural spit as he is fearful of “choking” to death. During panic attacks he immediately reports “choking” which furthers his panic. You are the first practitioner I have come across that has explained the relationship between globus pharyngeus, stress reaction and low GABA levels. I always felt his throat tightening (involuntary muscle response) was a stress response but was not aware of it’s connection to GABA levels. Thank you for this informative piece!

I voiced my concern for what her son was going through and how I can’t imagine how scary it must be for someone his age, asking her to keep us updated on his progress.

And just over a month later she reported the success her son was having with GABA:

We started a GABA supplement which has positively impacted my son. While he still struggles with hypersalivation when in distress or anxious, his self-reports of feeling like he is “choking” or his throat is closing, has not been present since GABA has been started. We are about a month in and I am inspired that we will continue to have progress. I have been referring to your work as a source to everyone I know that struggles with anxiety. Thank you for all that you do from a very grateful parent.

What wonderful results for her son! Getting feedback like this warms my heart and I appreciate her for sharing so I can share here.

I did ask what GABA product he was using, how much/how often he uses it and how quickly he noticed an improvement but did not hear back. My recommendation is 125mg to start for adults and less for children and I like the GABA Calm product as it’s a sublingual form and easy to use for kids.

I also commented on the fact that he still has “hypersalivation when in distress or anxious.” I would focus on trying to reduce the anxiety with higher doses of GABA and also consider addressing low serotonin because of the anxiety, panic attacks and being “fearful of “choking” to death”.

The anxiety could trigger hypersalivation but the hypersalivation could also be as a result of a food sensitivity like gluten or dairy. Both these and other food sensitivities could also contribute to low GABA/low serotonin and be a trigger for anxiety.

Of course, bullying at school should always be considered and so should the social anxiety condition pyroluria, speech therapy, gut health and vagus nerve support.

Could this be a case of laryngopharyngeal reflux (LPR)?

I always like to try and connect the dots and wonder if this could be a case of laryngopharyngeal reflux (LPR)? I don’t know but it’s possible. This paper, Laryngopharyngeal reflux: A confounding cause of aerodigestive dysfunction, states that LPR is “defined by the retrograde passage of gastric contents beyond the upper oesophageal sphincter, with contamination of the larynx, pharynx and lungs” and states that “half of the laryngeal complaints referred to ear, nose and throat (ENT) services are ultimately diagnosed as LPR.

It also mentions globus pharyngeus and dysphagia (which is difficulty swallowing), sharing that changes in pH suggest reflux occurs in “50% of patients with hoarseness, 64% with globus, 55% with chronic cough and 35% with dysphagia.”

This same paper reports that “30% of patients with LPR-like symptoms report anxiety, compared with 6% of healthy controls.”

Prevalence of reflux disease in children and LPR symptoms by age

This paper, Laryngopharyngeal Reflux Disease in Children, reports that “Although the exact prevalence is unknown, it is estimated that nearly 1 in 5 children likely suffers from reflux disease.” This 1 in 5 number is for both GERD (gastroesophageal reflux disease) and LPR.

The authors also share that it usually presents with a different set of symptoms depending on age:

Infants typically present with regurgitation, vomiting, dysphagia [difficulty swallowing], anorexia, failure to thrive, apnea, recurrent croup, laryngomalacia [softening of the laryngeal structure], subglottic stenosis [narrowing of the airway], or chronic respiratory issues.
School-age children tend to demonstrate chronic cough, dyspnea [shortness of breath], dysphonia [hoarseness], persistent sore throat, halitosis [bad breath], and globus sensation.
Older children may also complain of regurgitation, heartburn, vomiting, nausea, or have chronic respiratory issues.

Low levels of GABA, a calming neurotransmitter

In case you’re new to 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. Low GABA may be one possible root cause of globus pharyngeus, which leads to a rather scary golf-ball-like lump or constriction in the throat – or as this young boy describes, episodes of “choking” or tightening in his throat.

The amino acid GABA raises GABA levels and in this instance helps ease this tightening, choking or throat muscle spasms.

To be clear, there is no research (yet) on the use of the amino acid GABA for these types of symptoms, however in one study gabapentin was compared to baclofen for the treatment of gastro-oesophageal reflux-induced chronic cough and in another study there were improvements with both proton pump inhibitors and gabapentin for globus pharyngeus. If GABA works I’m all for it, rather than these medications, which do have a long list of side-effects.

Has your child been diagnosed with globus pharyngeus or laryngopharyngeal reflux disease?

Have you observed episodes like this in your child, personally or with clients/patients and has GABA helped?

Have you found other contributing factors like low serotonin, food sensitivities, gut issues, vagus nerve issues or pyroluria?

Feel free to post your questions here on the blog too.

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

July 3, 2020 By Trudy Scott 42 Comments

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.”

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

May 29, 2020 By Trudy Scott 16 Comments

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.